Individual
STACIE LANE-O'BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.C.B.A.
Contact information
Practice address
8307 SPANISH RD, CEDAR RAPIDS, IA 52404-9036
(319) 330-0598
Mailing address
8307 SPANISH RD, CEDAR RAPIDS, IA 52404-9036
(319) 330-0598
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-13-14345
CO
Other
Enumeration date
01/08/2014
Last updated
01/08/2014
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