Individual
KATHLEENE LANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
9876 MAIN ST, SUITE 100, WOODSTOCK, GA 30188-3970
(770) 516-1050
Mailing address
4050 SOUTHWOOD CIR SW, APT 1117, ATLANTA, GA 30331-8817
(607) 280-9616
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/03/2015
Last updated
06/03/2015
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