Individual
JORDAN LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
66 WEST ST, PITTSFIELD, MA 01201-5861
(413) 629-1072
Mailing address
66 WEST ST, PITTSFIELD, MA 01201-5861
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/30/2021
Last updated
11/30/2021
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