| NPI | 1992008940 |
|---|---|
| Former Name | JENNIFER DAWN LANG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MN CC00158) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN CC00158) |
| 103TC0700X Psychologist Clinical (Licence: MN CC00158) | |
| Enumeration Date | 2010-12-14 |
| Last Update Date | 2023-12-07 |