Individual
KJERSTI LANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
112 12TH AVE RD, NAMPA, ID 83686-5011
(760) 846-0782
Mailing address
112 12TH AVE RD, NAMPA, ID 83686-5011
(208) 465-5433
(208) 466-5802
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-10216
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LAMFT-7747
ASSOCIATE MARRIAGE AND FAMILY THERAPIST
ID
01
—
LPC-10216
LICENSED PROFESSIONAL COUNSELOR (LPC)
ID
Enumeration date
07/24/2015
Last updated
08/08/2024
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