Individual
JENNIFER LANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1601 MURPHY DR, MAUMELLE, AR 72113-6187
(501) 803-3388
(501) 803-4272
Mailing address
18 WARWICK RD, LITTLE ROCK, AR 72205-1537
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
01-3P
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BCBS
5W643
AR
Enumeration date
12/06/2006
Last updated
07/08/2007
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