Provider Demographics
NPI:1255086872
Name:LANG, JANE DANELL (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JANE
Middle Name:DANELL
Last Name:LANG
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4924 BURKE DR
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70003-2612
Mailing Address - Country:US
Mailing Address - Phone:504-888-5269
Mailing Address - Fax:
Practice Address - Street 1:13855 RIVER RD
Practice Address - Street 2:
Practice Address - City:LULING
Practice Address - State:LA
Practice Address - Zip Code:70070-6220
Practice Address - Country:US
Practice Address - Phone:985-785-3155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-14
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1125235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist