Individual
AMANDA HOPE LANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1802 MILLENNIUM XING, FORT WAYNE, IN 46845-8700
(260) 444-8523
Mailing address
1802 MILLENNIUM XING, FORT WAYNE, IN 46845-8700
(260) 444-8523
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39004550A
IN
Other
Enumeration date
06/23/2023
Last updated
01/09/2024
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