| NPI | 1255605358 |
|---|---|
| Former Name | JENNIFER SUZANNE LANG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NC A14116) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: AK 172) |
| Enumeration Date | 2012-03-07 |
| Last Update Date | 2018-10-17 |