Individual
MS. KENYONA LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14950 POTOMAC HEIGHTS PL APT 204, WOODBRIDGE, VA 22191-6247
(704) 577-4576
Mailing address
14950 POTOMAC HEIGHTS PL APT 204, WOODBRIDGE, VA 22191-6247
(704) 577-4576
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904009514
VA
Other
Enumeration date
09/05/2007
Last updated
09/19/2016
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