Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | NP518 | ME |
NPI | 1053336438 |
---|---|
Provider Name | Dr. Renee Lang |
First Address | Brunswick, ME 04011-7135 |
Second Address | Portland, ME 04101-4210 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2006 |
Last Update Date | 15/10/2016 |