| NPI | 1336508274 |
|---|---|
| Other Name | AMANDA JEAN LANE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP5983) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: ND 541) |
| Enumeration Date | 2016-02-21 |
| Last Update Date | 2026-04-21 |