Provider Information for 1952886491
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Ms. RAVEN J LANG License Social Worke
Sex: Female
NPI: 1952886491
Last Updated: 2018-10-01
Certification Date:
Certification Date:
Details
Name | Value | ||||||||
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NPI | 1952886491 | ||||||||
Enumeration Date | 2018-10-01 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | NO | ||||||||
Status | Active | ||||||||
Mailing Address | 1303 DR MARTIN L KING JR AVE MOBILE, AL 36603-5341 United States Phone: 251-432-4117 | Fax:251-436-7765 | ||||||||
Primary Practice Address | 1303 DR MARTIN L KING JR AVE MOBILE, AL 36603-5341 United States Phone: 251-432-4117 | Fax:251-436-7765 | ||||||||
Secondary Practice Address(es) | 510 S WILSON AVE | ||||||||
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