Individual
DR. JOHN G LANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
721 BOND ST, ESPANOLA, NM 87532-2729
(505) 753-5811
(505) 747-3210
Mailing address
721 BOND ST, ESPANOLA, NM 87532-2729
(505) 753-5811
(505) 747-3210
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
318
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35068
—
NM
Enumeration date
09/22/2006
Last updated
01/28/2013
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