Healthcare Provider Details
I. General information
NPI: 1982149654
Provider Name (Legal Business Name): AIMEE LYNNE LANG M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/04/2017
Last Update Date: 05/04/2022
Certification Date: 05/04/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
308 13TH ST
BELGRADE MT
59714-3133
US
IV. Provider business mailing address
PO BOX 1054
BELGRADE MT
59714-1054
US
V. Phone/Fax
- Phone: 406-624-9311
- Fax:
- Phone: 406-624-9311
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | BBH-LCPC-LIC-22678 |
| License Number State | MT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: