Individual
ANGELO LAINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
193 E 32ND ST, 3, BROOKLYN, NY 11226-5517
(631) 933-4521
Mailing address
193 E 32ND ST, 3, BROOKLYN, NY 11226-5517
(631) 933-4521
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/20/2017
Last updated
03/20/2017
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