Provider Demographics
NPI:1861828352
Name:LANG, REBECCA ANN
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:ANN
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 1:518 AVENUE H
Mailing Address - Street 2:
Mailing Address - City:LEVELLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79336-3727
Mailing Address - Country:US
Mailing Address - Phone:806-897-9735
Mailing Address - Fax:806-568-2316
Practice Address - Street 1:1313 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:LEVELLAND
Practice Address - State:TX
Practice Address - Zip Code:79336-3921
Practice Address - Country:US
Practice Address - Phone:806-897-9735
Practice Address - Fax:806-568-2316
Is Sole Proprietor?:No
Enumeration Date:2013-09-17
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68776101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health