Individual
ANNIE JEAN LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1330 OAKRIDGE DR UNIT 105, FORT COLLINS, CO 80525-9651
(866) 523-4268
Mailing address
3425 COFFEE RD STE C2, MODESTO, CA 95355-1582
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/19/2020
Last updated
03/19/2020
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