| Doctor Name: | MS. LYNETTE LANGE |
| NPI Number: | 1003113713 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, LLPC |
| License Number: | 6401011751 |
| Business Practice Address: | 14930 Laplaisance Rd Suite 106 Monroe, MI - 481613880 |
| Business Phone Number: | 7342410180 |
| Business Fax Number: | |
| Mailing Address: | 14930 Laplaisance Rd, Suite 106 MONROE |
| State: | MI |
| Postal Code: | 481613880 |
| Phone Number: | 7342410180 |
| Fax Number: | |
| NPI Enumeration Date: | 02/15/2011 |
| NPI Last Update Date: | 02/15/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 6401011751 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |