Individual
MR. LANE WESTON WILLMOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8922 CUMING ST, OMAHA, NE 68114-2732
(402) 926-4373
Mailing address
679 N 15TH ST, BLAIR, NE 68008-1211
(402) 619-3209
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20140944
NE
Other
Enumeration date
11/06/2020
Last updated
11/06/2020
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