Individual
MRS. KELLY MARIE LANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A, L.L.P
Contact information
Practice address
42189 ANN ARBOR RD E, PLYMOUTH, MI 48170-4370
(734) 754-1172
Mailing address
42189 ANN ARBOR RD E, PLYMOUTH, MI 48170-4370
(734) 754-1172
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
L1021506
MI
Other
Enumeration date
12/05/2007
Last updated
08/16/2016
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