Individual
JESICA LANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
950A UNION RD STE 108, WEST SENECA, NY 14224-3432
(818) 241-6780
(818) 241-6853
Mailing address
PO BOX 767938, ROSWELL, GA 30076-7938
(818) 241-6780
(818) 241-6853
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-38088
NY
106S00000X
Behavior Technician
—
—
Other
Enumeration date
02/27/2018
Last updated
10/02/2020
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