Organization
BEHAVIORAL LANE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIAH LANE BCBA (OWNER)
(904) 250-0852
Entity
Organization
Contact information
Practice address
7603 ALTAMA RD, JACKSONVILLE, FL 32216-9309
(904) 250-0852
Mailing address
7603 ALTAMA RD, JACKSONVILLE, FL 32216-9309
(904) 250-0852
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
07/06/2021
Last updated
08/27/2024
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