Individual
ELIZABETH TILLEY LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
106 EASTWOOD DR, CARTERSVILLE, GA 30120-1981
(404) 723-5463
Mailing address
106 EASTWOOD DR, CARTERSVILLE, GA 30120-1981
(404) 723-5463
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
GA
Other
Enumeration date
05/31/2024
Last updated
05/31/2024
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