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Individual

MRS. SUSAN MARIE LANE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5419 BARBAROSSA AVE, SARASOTA, FL 34235-3507
(941) 587-1441
Mailing address
5419 BARBAROSSA AVE, SARASOTA, FL 34235-3507
(941) 587-1441

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary

Other

Enumeration date
01/29/2008
Last updated
01/29/2008
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