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Contact Information

THEODORE W LANE, PhD
1540 PURDUE DR STE 200
FAYETTEVILLE, NC28303-5510
 Phone: 910-867-8889
 Fax: 910-487-3061
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for THEODORE W LANE · (Male)

NPI Number 1023156932
Status Active
Credentials PhD
Entity Individual
Enumeration date 02/02/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • NC License # 1264
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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