Individual
JESSICA ANN LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5446 N ACADEMY BLVD, COLORADO SPRINGS, CO 80918-3644
(719) 598-5555
Mailing address
39 AVOCET LOOP, COLORADO SPRINGS, CO 80921-2455
(719) 600-1038
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-73251
CO
Other
Enumeration date
01/29/2020
Last updated
06/02/2024
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