Provider Demographics
NPI:1639429400
Name:LANG, ASHLEY (MS, LLP, PMH-C)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:LANG
Suffix:
Gender:F
Credentials:MS, LLP, PMH-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7935 S HURON RIVER DR
Mailing Address - Street 2:
Mailing Address - City:S ROCKWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:48179-9792
Mailing Address - Country:US
Mailing Address - Phone:734-925-1169
Mailing Address - Fax:
Practice Address - Street 1:23000 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:BROWNSTOWN
Practice Address - State:MI
Practice Address - Zip Code:48134-9265
Practice Address - Country:US
Practice Address - Phone:734-925-1169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist