| Doctor Name: | MRS. GINA L. DAVIS-LANE |
| NPI Number: | 1013221662 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW, LCADC, CCS |
| License Number: | 200031501 |
| Business Practice Address: | 238 Neptune Blvd 2b Neptune, NJ - 077538600 |
| Business Phone Number: | 7328977701 |
| Business Fax Number: | 7328977705 |
| Mailing Address: | 7 Harvey Ave, NEPTUNE |
| State: | NJ |
| Postal Code: | 077532521 |
| Phone Number: | 7328977701 |
| Fax Number: | 7328977705 |
| NPI Enumeration Date: | 08/05/2010 |
| NPI Last Update Date: | 08/05/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 200031501 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |