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Individual
SHAWNA RUSSELL LANE
Active
Individual
SHAWNA RUSSELL LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, LBA
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-26309
TX
103K00000X
Behavior Analyst
1401
TX
Other
Enumeration date
05/14/2012
Last updated
07/02/2018
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