Provider Demographics
NPI:1487936910
Name:JEFFERSON-LANG, LORETTA LOUISE (MA)
Entity type:Individual
Prefix:MRS
First Name:LORETTA
Middle Name:LOUISE
Last Name:JEFFERSON-LANG
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17002 FRENCH RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-2530
Mailing Address - Country:US
Mailing Address - Phone:832-439-0908
Mailing Address - Fax:
Practice Address - Street 1:17002 FRENCH RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-2530
Practice Address - Country:US
Practice Address - Phone:832-439-0908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-10
Last Update Date:2011-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist