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General NPI Number Information
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NPI Number | 1164851051
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Entity Type | Individual
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Provider Name | DOROTHEE LANG LCPC
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Gender | Female
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Dates
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Enumeration Date | 11/01/2013
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Last Update Date | 11/01/2013
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Provider Practice Location Address
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Address Line | 600 N WOLFE ST
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City | BALTIMORE
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State | MD
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Zip | 21287-0005
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Country | US
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Telephone | 703-789-2836
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Fax |
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Provider Business Mailing Address
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Address Line | 10 HEARTHSTONE CT APT F
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City | ANNAPOLIS
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State | MD
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Zip | 21403-5716
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Country | US
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Telephone | 703-789-2836
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LC4708
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License Number State | MD
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