Individual
DANA SHERRELL JACKSON LANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
811 COUNTY ROAD 159, BALLINGER, TX 76821-7311
(325) 374-4504
Mailing address
811 COUNTY ROAD 159, BALLINGER, TX 76821-7311
(325) 374-4504
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
54415
TX
1041C0700X
Clinical Social Worker
LCSW-4376
HI
Other
Enumeration date
05/06/2019
Last updated
05/06/2019
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