Individual
TAMARA LANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
9 CENTENNIAL DR, SUITE 202, PEABODY, MA 01960-7939
(978) 522-5055
Mailing address
9 CENTENNIAL DR, SUITE 202, PEABODY, MA 01960-7939
(978) 522-5055
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
3031612
MA
106H00000X
Marriage & Family Therapist
Primary
1178
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04-2867023
—
MA
Enumeration date
03/15/2017
Last updated
03/15/2017
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