| Dana Lane | |
|
14502 N Dale Mabry Hwy Suite 200-52 Tampa FL 33618-2075 | |
| (813) 240-5769 | |
| (813) 932-2588 |
| Full Name | Dana Lane |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 14502 N Dale Mabry Hwy, Tampa, Florida |
| Authorized Official Name and Position | Dana Lane (SOLE PROPRIETOR) |
| Authorized Official Contact | 8132405769 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dana Lane 2108 W Fore Dr Tampa FL 33612-5005 Ph: (813) 240-5769 | Dana Lane 14502 N Dale Mabry Hwy Suite 200-52 Tampa FL 33618-2075 Ph: (813) 240-5769 |
| NPI Number | 1073862892 |
|---|---|
| Provider Enumeration Date | 09/07/2012 |
| Last Update Date | 09/07/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073862892 | NPI | - | NPPES |
| 002664200 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH 2860 (Florida) | Primary |
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