Individual
MS. GINA M. LANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
4 SUELLEN CT, ISLIP, NY 11751-4107
(631) 219-5114
Mailing address
4 SUELLEN CT, ISLIP, NY 11751-4107
(631) 219-5114
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
03/10/2014
Last updated
03/10/2014
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