Individual
HEATHER LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1280 W WASHINGTON BLVD, CHICAGO, IL 60607-1930
(630) 730-5263
Mailing address
300 W HILL ST, UNIT 407, CHICAGO, IL 60610-2549
(630) 730-5263
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
05/27/2015
Last updated
05/27/2015
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