person
Mr. Leonard Wallace Lane JR., MFTINTERN
Mental Health Counselor in Los Angeles, California
NPI 1770095879

Leonard Wallace Lane JR. is a Mental Health Counselor based in Los Angeles, CA and is specialized in Mental Health. Leonard Wallace Lane JR. practices in Los Angeles, CA and has the professional credentials of MFTINTERN. The NPI Number for Leonard Wallace Lane JR. is 1770095879 and holds a License No. 76583 (California).

The current practice location address for Leonard Wallace Lane JR. is 1926 Beverly Blvd, Los Angeles, CA and can be reached out via phone at 213-353-1140 and via fax at 213-353-1151.

Location: 1926 Beverly Blvd, Los Angeles, CA, 90057-2402
person
Provider Profile Details
NPI Number
1770095879
Provider Name
Leonard Wallace Lane JR.
Credential
MFTINTERN
Provider Entity Type
Individual
Gender
Male
Address
1926 Beverly Blvd, Los Angeles, CA, 90057-2402
Phone Number
213-353-1140
Fax Number
213-353-1151
Provider Enumeration Date
10/30/2017
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1926 Beverly Blvd
City
State
Zip
90057-2402
Phone Number
213-353-1140
Fax Number
213-353-1151
person
Provider Business Mailing Address Details
Address
1926 Beverly Blvd
City
State
Zip
90057-2402
Phone Number
213-353-1140
Fax Number
213-353-1151
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
76583 (California)
Definition
Definition to come...
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