Justice Marie Lane

NPI #1679208060 in Cheyenne, Wyoming

Provider Information

NPI Number: 1679208060
Entity Type: Individual
Name: Justice Marie Lane
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Jul 19, 2022
Last Updated: Jul 19, 2022

Practice Location

Address: 3120 OLD FAITHFUL RD
City: Cheyenne
State: Wyoming
ZIP Code: 82001-5865
Phone: (307) 369-1410

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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