Individual
DEBRA LANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11110 W WINDSOR AVE, AVONDALE, AZ 85323-5875
(623) 907-5428
Mailing address
11110 W WINDSOR AVE, AVONDALE, AZ 85323-5875
(623) 907-5428
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
10432
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
968696
—
AZ
Enumeration date
01/22/2007
Last updated
07/09/2007
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