Organization
TYRONE D. LANE ENTERPRISES, INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TYRONE D. LANE MPSY (PRESIDENT/CEO)
(678) 677-4041
Entity
Organization
Contact information
Practice address
5304 PANOLA INDUSTRIAL BOULEVARD, SUITE L, DECATUR, GA 30035
(678) 677-4041
Mailing address
5304 PANOLA INDUSTRIAL BOULEVARD, SUITE L, DECATUR, GA 30035
(678) 677-4041
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251V00000X
Voluntary or Charitable Agency
—
—
Other
Enumeration date
02/12/2014
Last updated
02/12/2014
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