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Individual

MS. EMILY LANGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCADC

Contact information

Practice address
250 W LOUDON AVE, LEXINGTON, KY 40508-1272
(859) 254-6732
Mailing address
250 W LOUDON AVE, LEXINGTON, KY 40508-1272
(859) 254-6732

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
275062
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PENDING
KY
Enumeration date
04/13/2022
Last updated
04/13/2022
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