| Kelly M. Lange, M.a, L.l.p | |
|
496 W Ann Arbor Trl Ste 106 Plymouth MI 48170-6262 | |
| (734) 754-1172 | |
| Not Available |
| Full Name | Kelly M. Lange, M.a, L.l.p |
|---|---|
| Speciality | Psychologist |
| Location | 496 W Ann Arbor Trl Ste 106, Plymouth, Michigan |
| Authorized Official Name and Position | Kelly Marie Lange (CLINICIAN) |
| Authorized Official Contact | 7347541172 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly M. Lange, M.a, L.l.p 41422 Strawberry Ct Canton MI 48188-5244 Ph: (734) 754-1172 | Kelly M. Lange, M.a, L.l.p 496 W Ann Arbor Trl Ste 106 Plymouth MI 48170-6262 Ph: (734) 754-1172 |
| NPI Number | 1194366807 |
|---|---|
| Provider Enumeration Date | 10/03/2019 |
| Last Update Date | 10/03/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194366807 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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