Individual
WILLECIA LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
4646 POPLAR AVE, MEMPHIS, TN 38117-4426
(901) 443-8895
Mailing address
1996 NORTHPORT RD APT 2, CORDOVA, TN 38016-3882
(901) 462-4843
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/19/2021
Last updated
01/19/2021
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