Individual
AMANDA LANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11808 N OHIO ST, DUNNELLON, FL 34431-6724
(352) 342-5006
Mailing address
2389 SW 156TH LOOP, OCALA, FL 34473-3459
(352) 208-3724
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
24347499
FL
Other
Enumeration date
05/15/2024
Last updated
05/15/2024
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