Provider Demographics
NPI:1992344261
Name:DR. JANE, LLC
Entity type:Organization
Organization Name:DR. JANE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANE
Authorized Official - Middle Name:WALLIS
Authorized Official - Last Name:TURNBULL-HUMPHRIES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC, NCC
Authorized Official - Phone:334-740-1390
Mailing Address - Street 1:311 N COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-3814
Mailing Address - Country:US
Mailing Address - Phone:334-740-1390
Mailing Address - Fax:
Practice Address - Street 1:311 N COLLEGE ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-3814
Practice Address - Country:US
Practice Address - Phone:334-740-1390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-03
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)