Individual
CANDICE LANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
125 PENFIELD RD, FAIRFIELD, CT 06824-6611
(203) 255-5777
Mailing address
125 PENFIELD RD, FAIRFIELD, CT 06824-6611
(203) 255-5777
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
003821
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004069985
—
CT
Enumeration date
09/04/2019
Last updated
09/04/2019
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