Provider Demographics
NPI:1528604782
Name:LANG, KATELYNN JOSEPHINE (MS ED, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KATELYNN
Middle Name:JOSEPHINE
Last Name:LANG
Suffix:
Gender:F
Credentials:MS ED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4845 TRANSIT RD APT 413
Mailing Address - Street 2:
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-4662
Mailing Address - Country:US
Mailing Address - Phone:716-462-8269
Mailing Address - Fax:
Practice Address - Street 1:6048 GODFREY RD
Practice Address - Street 2:
Practice Address - City:BURT
Practice Address - State:NY
Practice Address - Zip Code:14028-9722
Practice Address - Country:US
Practice Address - Phone:716-731-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-22
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029274235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist