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:
Health care specialties
Specialty | Code | License # | 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 16 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1144372756 | NPPES |
Florida | MEDICAID | 811824800 | |
Florida | MEDICAID | 767404000 |
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