| Doctor Name: | KATHLEENE LANGE |
| NPI Number: | 1598145765 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA |
| License Number: | |
| Business Practice Address: | 9876 Main St Suite 100 Woodstock, GA - 301883970 |
| Business Phone Number: | 7705161050 |
| Business Fax Number: | |
| Mailing Address: | 4050 Southwood Cir Sw, Apt 1117 ATLANTA |
| State: | GA |
| Postal Code: | 303318817 |
| Phone Number: | 6072809616 |
| Fax Number: | |
| NPI Enumeration Date: | 06/03/2015 |
| NPI Last Update Date: | 06/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |