Individual
LANE CHAZDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCAT, MME, MT-BC
Contact information
Practice address
2094 ALBANY POST RD, MONTROSE, NY 10548-1454
(914) 737-4400
Mailing address
PO BOX 100, MONTROSE, NY 10548
(914) 737-4400
Taxonomy
Speciality
Code
Description
License number
State
225A00000X
Music Therapist
Primary
0000462-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000462-1
NY STATE LICENSE
NY
01
—
8445678
NY STATE LICENSE CERTIFICATION
NY
Enumeration date
08/31/2016
Last updated
08/31/2016
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