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Individual
EMILY LANE
Active
Individual
EMILY LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-62974
—
106S00000X
Behavior Technician
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-22-62974
BEHAVIOR ANALYST CERTIFICATION BOARD
—
Enumeration date
06/21/2018
Last updated
07/30/2024
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