Individual
JENNIFER LANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
178.006966
IL
101YP2500X
Professional Counselor
Primary
180.009118
IL
Other
Enumeration date
11/13/2013
Last updated
12/08/2014
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