Individual
MRS. BONNIE DENTON LANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3 MYSTIC CT, STONY BROOK, NY 11790-2920
(631) 751-0058
Mailing address
3 MYSTIC CT, STONY BROOK, NY 11790-2920
(631) 751-0058
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R019517
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080958
VALUE OPTIONS
NY
Enumeration date
02/16/2007
Last updated
07/08/2007
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