Individual
SUSAN LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
1306 RIO GRANDE BLVD NW, SUITE B, ALBUQUERQUE, NM 87104-2633
(505) 830-1200
(505) 830-1203
Mailing address
1306 RIO GRANDE BLVD NW, SUITE B, ALBUQUERQUE, NM 87104-2633
(505) 830-1200
(505) 830-1203
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0088191
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0088191
—
NM
Enumeration date
06/14/2006
Last updated
12/18/2007
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