Individual
JENNIFER ANNE LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
4255 BEETOW DR, HAMBURG, NY 14075-1502
(716) 648-7061
Mailing address
4255 BEETOW DR, HAMBURG, NY 14075-1502
(716) 648-7061
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
003867-1
NY
Other
Enumeration date
07/10/2007
Last updated
07/10/2007
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