Provider Demographics
NPI:1447535729
Name:LANYON, JANE KNIGHT (PSYD)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:KNIGHT
Last Name:LANYON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2204 LAKESHORE DR
Mailing Address - Street 2:SUITE 170
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-6729
Mailing Address - Country:US
Mailing Address - Phone:205-397-4783
Mailing Address - Fax:205-868-6696
Practice Address - Street 1:1200 CORPORATE DR
Practice Address - Street 2:SUITE 125
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-2941
Practice Address - Country:US
Practice Address - Phone:205-329-7992
Practice Address - Fax:205-329-7999
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-18
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL614103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical