Individual
CHARITY R LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1737 S NAPERVILLE RD, WHEATON, WHEATON, IL 60189-5894
(630) 653-9700
Mailing address
910 PERSHING AVE, WHEATON, IL 60189-6565
(260) 494-7037
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071010522
IL
Other
Enumeration date
03/21/2011
Last updated
02/14/2023
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