Individual
CHASERIE SYMONE LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3875 TIGER PAW ST S, MEMPHIS, TN 38152-3920
(901) 678-5059
Mailing address
4389 BIRMINGHAM LN APT 305, MEMPHIS, TN 38125-2034
(901) 871-7374
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
20-139605
TN
Other
Enumeration date
10/13/2020
Last updated
10/13/2020
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