Individual
MRS. LIA M LAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
890 ELM GROVE RD, VILLAGE COURT BUILDINGS SUITE #205, ELM GROVE, WI 53122-2528
(262) 780-0991
Mailing address
890 ELM GROVE RD, SUITE 205, ELM GROVE, WI 53122-2528
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4975-125
WI
Other
Enumeration date
05/08/2013
Last updated
04/28/2014
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