Provider Demographics
NPI:1104531391
Name:LANE, KATHRYN MORGAN (BCBA, LBA, MA)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MORGAN
Last Name:LANE
Suffix:
Gender:F
Credentials:BCBA, LBA, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 KRAMER LN STE 150
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-4096
Mailing Address - Country:US
Mailing Address - Phone:512-771-5677
Mailing Address - Fax:
Practice Address - Street 1:2100 KRAMER LN STE 150
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-4096
Practice Address - Country:US
Practice Address - Phone:512-771-5677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst