JEREMY DAVID LANE

ROME, GA
NPI1154695625
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: GA  LPC006218)
Enumeration Date2012-03-01
Last Update Date2012-03-01
Business Address
-- JEREMY DAVID LANE LPC, NCC
309 E 3RD ST APT 5
ROME, GA 30161-3194
Phone number: 404-425-6264
Mailing Address
-- JEREMY DAVID LANE LPC, NCC
309 EAST 3RD ST. (APT. 5)
ROME, GA 30161
Phone number: 404-425-6264
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