Individual
MRS. JESSICA LANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., LPC
Contact information
Practice address
12720 W NORTH AVE, BUILDING B SUITE 200, BROOKFIELD, WI 53005-4637
(262) 285-1500
(262) 785-1555
Mailing address
12720 W NORTH AVE, BUILDING B, SUITE 200, BROOKFIELD, WI 53005-4637
(262) 785-1500
(262) 785-1555
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4525-125
WI
Other
Enumeration date
03/01/2011
Last updated
02/10/2015
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