Individual
ANDREW LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6609 MANCHACA RD, AUSTIN, TX 78745-4934
(512) 387-7178
Mailing address
6609 MANCHACA RD, AUSTIN, TX 78745-4934
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
77712
TX
Other
Enumeration date
10/15/2019
Last updated
10/15/2019
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