Individual
HAZEL LAVERN LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
9939 STATE HIGHWAY 151, SAN ANTONIO, TX 78251-1900
(210) 861-8429
Mailing address
15115 CARTWRIGHT TRL, SAN ANTONIO, TX 78253-4685
(210) 861-8429
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
36266
TX
Other
Enumeration date
01/17/2023
Last updated
01/17/2023
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