Individual
JESSICA LAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2855 E BROWN RD, MESA, AZ 85213-4213
(480) 997-1220
Mailing address
941 E MESQUITE ST, GILBERT, AZ 85296-1808
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/31/2025
Last updated
01/31/2025
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