| NPI | 1770147548 |
|---|---|
| Doing Business As | MARY JANE LANE LMFT LLC |
| Entity Type | Organization |
| Authorized Contact | MARY JANE LANE Provider 314-805-2947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-04-27 |
| Last Update Date | 2019-06-11 |