Individual
KOURTNEY NOELLA LANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10 PARSONAGE RD, EDISON, NJ 08837-2429
(732) 204-1635
Mailing address
238 MORNING GLORY DR, MONROE TOWNSHIP, NJ 08831-5340
(908) 510-7606
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/13/2018
Last updated
08/13/2018
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