Jordan Tanner Lane is a Peer Specialist based in Yukon, OK. Jordan Tanner Lane practices in Yukon, OK. The NPI Number for Jordan Tanner Lane is 1891493060 and holds a License No. (Oklahoma).
The current practice location address for Jordan Tanner Lane is 9217 Nw 71St St, Yukon, OK and can be reached out via phone at 405-651-8162.
Location: 9217 Nw 71St St, Yukon, OK, 73099-7445
Provider Profile Details
NPI Number
1891493060
Provider Name
Jordan Tanner Lane
Credential
Provider Entity Type
Individual
Gender
Male
Address
9217 Nw 71St St, Yukon, OK, 73099-7445
Phone Number
405-651-8162
Fax Number
Provider Enumeration Date
02/17/2023
Last Update Date
03/10/2024
Provider Business Practice Location Address Details
Address
9217 Nw 71St St
City
State
Zip
73099-7445
Phone Number
405-651-8162
Fax Number
Provider Business Mailing Address Details
Address
9217 Nw 71St St
City
State
Zip
73099-7445
Phone Number
405-651-8162
Fax Number
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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