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Individual

EMILY LANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BCBA

Contact information

Practice address
1026 W ABRIENDO AVE, PUEBLO, CO 81004-1128
(719) 252-3327
Mailing address
5316 SPARROW HAWK WAY, COLORADO SPRINGS, CO 80911-3624
(303) 641-0058

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-62974
106S00000X
Behavior Technician
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1-22-62974
BEHAVIOR ANALYST CERTIFICATION BOARD
Enumeration date
06/21/2018
Last updated
07/30/2024
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