| Doctor Name: | ABIGAIL LANE |
| NPI Number: | 1083017040 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW, LICSW |
| License Number: | 21249 |
| Business Practice Address: | 901 Brookdale Dr Brooklyn Park, MN - 554442121 |
| Business Phone Number: | 7632272054 |
| Business Fax Number: | |
| Mailing Address: | 701 Decatur Ave N Ste 109, GOLDEN VALLEY |
| State: | MN |
| Postal Code: | 554274363 |
| Phone Number: | 7632272054 |
| Fax Number: | |
| NPI Enumeration Date: | 10/06/2014 |
| NPI Last Update Date: | 10/06/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 21249 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |