Individual
MELANIE LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
208 GOVERNOR ST, PROVIDENCE, RI 02906-3246
(401) 490-3563
(401) 490-3569
Mailing address
208 GOVERNOR ST, PROVIDENCE, RI 02906-3246
(401) 490-3563
(401) 490-3569
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW01218
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
413302
BLUE CHIP
RI
Enumeration date
10/16/2006
Last updated
07/08/2007
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