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Individual

MRS. JENNIFER LANE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LISW

Contact information

Practice address
1001 COVINGTON ST, YOUNGSTOWN, OH 44510-1617
(330) 480-2616
(330) 480-7979
Mailing address
1001 COVINGTON ST, YOUNGSTOWN, OH 44510-1617
(330) 480-2616
(330) 480-7979

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I.1600155
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0211871
OH
Enumeration date
04/18/2016
Last updated
11/07/2019
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