Provider Demographics
NPI:1932967569
Name:LANE, KARLA KRISTINE (MA)
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:KRISTINE
Last Name:LANE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85888 GRABNER LANE
Mailing Address - Street 2:
Mailing Address - City:MILTON FREEWATER
Mailing Address - State:OR
Mailing Address - Zip Code:97862
Mailing Address - Country:US
Mailing Address - Phone:541-969-1132
Mailing Address - Fax:
Practice Address - Street 1:85888 GRABNER LANE
Practice Address - Street 2:
Practice Address - City:MILTON FREEWATER
Practice Address - State:OR
Practice Address - Zip Code:97862
Practice Address - Country:US
Practice Address - Phone:541-969-1132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health