Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | NCFBPPC27 | NC |
NPI | 1003894254 |
---|---|
Provider Name | Carla Lang |
First Address | Greensboro, NC 27403-1149 |
Second Address | Greensboro, NC 27403-1149 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2006 |
Last Update Date | 08/07/2007 |