Individual
BRIAN THOMAS LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
40 BERGEN AVE, WALDWICK, NJ 07463-1936
(201) 410-7699
Mailing address
40 BERGEN AVE, WALDWICK, NJ 07463-1936
(201) 410-7699
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC739
NJ
Other
Enumeration date
03/20/2007
Last updated
07/08/2007
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