| Mary Jane Lane Lmft Llc | |
|
412 S Clay Ave # 212 Kirkwood MO 63122-5860 | |
| (314) 805-2977 | |
| (314) 822-9696 |
| Full Name | Mary Jane Lane Lmft Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 412 S Clay Ave # 212, Kirkwood, Missouri |
| Authorized Official Name and Position | Mary Jane Lane (PROVIDER) |
| Authorized Official Contact | 3148052947 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Jane Lane Lmft Llc 412 S Clay Ave # 212 Kirkwood MO 63122-5860 Ph: (314) 805-2977 | Mary Jane Lane Lmft Llc 412 S Clay Ave # 212 Kirkwood MO 63122-5860 Ph: (314) 805-2977 |
| NPI Number | 1770147548 |
|---|---|
| Provider Enumeration Date | 04/27/2019 |
| Last Update Date | 06/11/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770147548 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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