Individual
ANDREA LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1875 STATION PKWY NW, ANDOVER, MN 55304
(763) 482-9598
Mailing address
1875 STATION PKWY NW, ANDOVER, MN 55304-3319
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
305243
MN
Other
Enumeration date
10/27/2020
Last updated
07/27/2022
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