Individual
ELIZABETH LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
TCM
Contact information
Practice address
1563 ALHAMBRA WAY S, ST PETERSBURG, FL 33705-4625
(727) 433-0475
Mailing address
1563 ALHAMBRA WAY S, ST PETERSBURG, FL 33705-4625
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/03/2017
Last updated
10/03/2017
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