Individual
MRS. DEBRA LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8270 WILLOW OAKS CORPORATE DR, FAIRFAX, VA 22031-4511
(703) 208-2418
Mailing address
8270 WILLOW OAKS CORPORATE DR, FAIRFAX, VA 22031-4511
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
0813000473
VA
Other
Enumeration date
04/02/2018
Last updated
04/02/2018
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