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Individual

KATHLEEN R LANGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.T.

Contact information

Practice address
3919 N PINE GROVE AVE, APARTMENT #1E, CHICAGO, IL 60613-3372
(773) 327-8041
Mailing address
3919 N PINE GROVE AVE, APARTMENT #1E, CHICAGO, IL 60613-3372
(773) 327-8041

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary

Other

Enumeration date
07/27/2011
Last updated
07/27/2011
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