| NPI | 1770199093 |
|---|---|
| Former Name | STEPHANIE LANE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2020043179) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2020-09-22 |
| Last Update Date | 2026-07-15 |