Individual
CHANNING E LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11607 SOUTHFORK AVE, BATON ROUGE, LA 70816-5220
(888) 880-9270
Mailing address
18739 MANCHAC POINT RD, PRAIRIEVILLE, LA 70769-6048
(225) 244-4972
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
LA
Other
Enumeration date
05/28/2024
Last updated
06/03/2024
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