Individual
MS. BETSY LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, CSAC
Contact information
Practice address
1541 ANNEX RD, JEFFERSON, WI 53549-9803
(920) 674-3105
Mailing address
1541 ANNEX RD, JEFFERSON, WI 53549-9803
(920) 674-3105
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
17042-132
WI
101YP2500X
Professional Counselor
Primary
7641-125
WI
Other
Enumeration date
09/09/2015
Last updated
04/29/2024
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