Individual
CICELY LANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9245 DOROTHY DR, STREETSBORO, OH 44241-8309
(330) 842-9008
Mailing address
9245 DOROTHY DR, STREETSBORO, OH 44241-8309
(330) 842-9008
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
2267274
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2267274
—
OH
Enumeration date
06/05/2007
Last updated
07/09/2007
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