Provider Demographics
NPI:1720816242
Name:LANE, DANIELLE JANICE
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:JANICE
Last Name:LANE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 ASH LN
Mailing Address - Street 2:
Mailing Address - City:DAKOTA CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68731-4081
Mailing Address - Country:US
Mailing Address - Phone:712-899-6561
Mailing Address - Fax:
Practice Address - Street 1:109 ASH LN
Practice Address - Street 2:
Practice Address - City:DAKOTA CITY
Practice Address - State:NE
Practice Address - Zip Code:68731-4081
Practice Address - Country:US
Practice Address - Phone:712-899-6561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No101Y00000XBehavioral Health & Social Service ProvidersCounselor