Individual
MR. MICHAEL JOSEPH LANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., L.P.
Contact information
Practice address
1703 CSAH 15, ST. PETER, MN 56082
(507) 933-5033
Mailing address
32298 STATE HIGHWAY 13, MONTGOMERY, MN 56069-4348
(507) 933-5033
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP3351
MN
171M00000X
Case Manager/Care Coordinator
LP3351
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LP3351
PSYCHOLOGY LICENSE
—
Enumeration date
08/20/2007
Last updated
08/02/2022
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