Individual
KATHLEEN MARIE LANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
829 CHIEF EDDIE HOFFMAN HWY, SUITE 150, BETHEL, AK 99559-0528
(907) 543-6100
(907) 543-6159
Mailing address
PO BOX 528, ATTN: BEHAVIORAL HEALTH, BETHEL, AK 99559-0528
(907) 543-6100
(907) 543-6159
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020986
—
AK
Enumeration date
10/30/2014
Last updated
10/30/2014
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