| Eric J Lane Psy D Pa | |
|
1104 Kenilworth Dr Suite 302 Towson MD 21204-2101 | |
| (443) 280-2916 | |
| (410) 377-4844 |
| Full Name | Eric J Lane Psy D Pa |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1104 Kenilworth Dr, Towson, Maryland |
| Authorized Official Name and Position | Eric J Lane (PRESIDENT) |
| Authorized Official Contact | 4432802916 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eric J Lane Psy D Pa 1104 Kenilworth Dr Suite 302 Towson MD 21204-2101 Ph: (443) 280-2916 | Eric J Lane Psy D Pa 1104 Kenilworth Dr Suite 302 Towson MD 21204-2101 Ph: (443) 280-2916 |
| NPI Number | 1366727034 |
|---|---|
| Provider Enumeration Date | 10/13/2011 |
| Last Update Date | 10/13/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366727034 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 04531 (Maryland) | Primary |
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