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NPI Profile for PENELOPE D LANE in WACO, TX.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X | |||
School |
103TS0200X | 62 | Psychologist, Clinical |
| NPI # | 1881038776 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 04/22/2013 | |
| Last updated | 04/22/2013 - About 13 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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PENELOPE D LANE
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PENELOPE D LANE