Individual
DR. ADRIANNE ELIZABETH LANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1190 E BROADWAY, LOUISVILLE, KY 40204-1712
(502) 309-2408
(502) 771-4283
Mailing address
1607 NORRIS PL, LOUISVILLE, KY 40205-1227
(646) 236-7445
(000) 000-0000
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
242609
KY
1041S0200X
School Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300006191
—
IN
05
—
7100482680
—
KY
01
—
K249650
MEDICARE
KY
01
—
P01887352
RR MEDICARE
KY
Enumeration date
06/03/2010
Last updated
04/10/2019
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