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Individual

JENNIFER L LANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
1 MEDICAL PARK, WHEELING HOSPITAL INC, WHEELING, WV 26003-6379
(304) 243-3195
Mailing address
1 MEDICAL PARK, WHEELING HOSPITAL INC, WHEELING, WV 26003-6379
(304) 243-3195

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
584
WV
225X00000X
Occupational Therapist
OT.003855
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
584
LICENSE
WV
01
OT.003855
LICENSE
OH
Enumeration date
11/23/2010
Last updated
11/23/2010
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