Provider Demographics
NPI:1174187306
Name:LANG, ANGELA NOEL (MED, BCBA, COBA, LB)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:NOEL
Last Name:LANG
Suffix:
Gender:F
Credentials:MED, BCBA, COBA, LB
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:BUECHEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:128 MARSHALL LN
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND HEIGHTS
Mailing Address - State:KY
Mailing Address - Zip Code:41076-1440
Mailing Address - Country:US
Mailing Address - Phone:859-760-8109
Mailing Address - Fax:
Practice Address - Street 1:615 LORELEI DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:OH
Practice Address - Zip Code:45118-8409
Practice Address - Country:US
Practice Address - Phone:859-760-8109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-23
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-18-59463106S00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1-20-44150OtherBACB
RBT-18-59463OtherRBT