| NPI | 1528358512 |
|---|---|
| Former Name | JACQUELYNN M LANE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 374700000X Technician (Licence: AK 630534) |
| Enumeration Date | 2011-04-12 |
| Last Update Date | 2011-04-12 |