Individual
JESSICA LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS LBA, BCBA
Contact information
Practice address
6 CHELSEA PLACE, SUITE 202, CLIFTON PARK, NY 12065
(518) 982-1886
(518) 734-0276
Mailing address
6 CHELSEA PLACE, P.O. BOX 405, SUITE 202, CLIFTON PARK, NY 12065
(518) 982-1886
(518) 734-0276
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
001084
NY
Other
Enumeration date
07/11/2016
Last updated
11/16/2018
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