Provider Demographics
NPI:1205372646
Name:LANG, ABBY E (MA, BCBA , COBA)
Entity Type:Individual
Prefix:MRS
First Name:ABBY
Middle Name:E
Last Name:LANG
Suffix:
Gender:F
Credentials:MA, BCBA , COBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1483 ROSEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-3733
Mailing Address - Country:US
Mailing Address - Phone:330-931-9582
Mailing Address - Fax:
Practice Address - Street 1:36711 AMERICAN WAY
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:OH
Practice Address - Zip Code:44011-4062
Practice Address - Country:US
Practice Address - Phone:216-282-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-09
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1-22-62788103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst