MR. William Bradford Lane JR., LPC

NPI #1124542147 in Pocatello, Idaho

Provider Information

NPI Number: 1124542147
Entity Type: Individual
Name: MR. William Bradford Lane JR., LPC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor
Credential: LPC
Enumeration Date: Aug 1, 2017
Last Updated: Jul 21, 2022

Practice Location

Address: 409 WASHINGTON AVE
City: Pocatello
State: Idaho
ZIP Code: 83201-4520
Phone: (208) 234-2646

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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