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Individual

OLIVIA LANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M. ED., BCBA

Contact information

Practice address
4612 S HARVARD AVE, TULSA, OK 74135-2908
(918) 986-1560
(918) 459-4550
Mailing address
4612 S HARVARD AVE, TULSA, OK 74135-2908
(918) 986-1560
(918) 459-4550

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-41072
OK
106S00000X
Behavior Technician
RBT-19-83192

Other

Enumeration date
09/13/2019
Last updated
03/05/2020
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