Most Relevant Information
Provider Data
| NPI Number: | 1003656547 |
| Provider Name: | ELIZABETH TILLEY LANE |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/31/2024 |
| Last Updated: | 05/31/2024 |
Provider Practice Location
106 EASTWOOD DR
CARTERSVILLE
GA
301201981
Practice Location Phone/Fax
| Phone: | 4047235463 |
| Fax: |
Provider Mailing Location
106 EASTWOOD DR
CARTERSVILLE
GA
301201981
Provider Mailing Phone/Fax
| Phone: | 4047235463 |
| Fax: |