Individual
LISA LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2480 MAVERICK ST, LAS VEGAS, NV 89108-3824
(702) 799-1883
Mailing address
2480 MAVERICK ST, LAS VEGAS, NV 89108-3824
(702) 799-1883
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT4293
NV
Other
Enumeration date
01/09/2025
Last updated
01/09/2025
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