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Individual

SHANEEN LANG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3161 CUSTER DR STE 4, LEXINGTON, KY 40517-4067
(859) 977-6080
(859) 977-4502
Mailing address
3161 CUSTER DR STE 4, LEXINGTON, KY 40517-4067
(859) 977-6080
(859) 977-4502

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1790731081
KY
Enumeration date
07/29/2015
Last updated
07/29/2015
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