Lane, Coletha P

Lane, Coletha P is an individual health care provider with primary practice located at 910 N Jefferson St , Jacksonville FL 32209-6810. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Social Worker is her primary health care specialty. Lane, Coletha P can be contacted via phone (904) 360-7022.

Contact Information

Primary practice address
910 N Jefferson St Jacksonville FL 32209-6810
Phone: (904) 360-7022
Fax: (904) 798-4544
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist 222Q00000X
Behavioral Health & Social Service Providers / Social Worker 104100000X

Profile Details

NPI number 1144372756
LBN Legal business name Lane, Coletha P
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 17th, 2007
Last updated Sep 30th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144372756 NPPES
Florida MEDICAID 811824800
Florida MEDICAID 767404000

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