Provider Demographics
NPI:1891535613
Name:LANG, BRYNN (LBSW)
Entity type:Individual
Prefix:
First Name:BRYNN
Middle Name:
Last Name:LANG
Suffix:
Gender:F
Credentials:LBSW
Other - Prefix:
Other - First Name:BRYNN
Other - Middle Name:
Other - Last Name:OLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:211 4TH ST NE STE 9
Mailing Address - Street 2:
Mailing Address - City:DEVILS LAKE
Mailing Address - State:ND
Mailing Address - Zip Code:58301-2479
Mailing Address - Country:US
Mailing Address - Phone:701-527-2034
Mailing Address - Fax:
Practice Address - Street 1:5523 YUKON DR
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-6812
Practice Address - Country:US
Practice Address - Phone:701-230-5004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator