Individual
CONNIE M LAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
237 E 6TH ST, RUSSELLVILLE, KY 42276-1917
(270) 726-3629
(270) 726-3620
Mailing address
108 GRASSMERE CT, PORTLAND, TN 37148-2356
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
0749
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30604011
—
KY
Enumeration date
03/22/2007
Last updated
09/22/2010
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