Provider Demographics
NPI:1477965523
Name:LANG, DIANA
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:LANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 CURTIS CT
Mailing Address - Street 2:
Mailing Address - City:CHESTERBROOK
Mailing Address - State:PA
Mailing Address - Zip Code:19087-1239
Mailing Address - Country:US
Mailing Address - Phone:484-318-8560
Mailing Address - Fax:
Practice Address - Street 1:401 CURTIS CT
Practice Address - Street 2:
Practice Address - City:CHESTERBROOK
Practice Address - State:PA
Practice Address - Zip Code:19087-1239
Practice Address - Country:US
Practice Address - Phone:919-607-9052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-23
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP001553L224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant