Provider Demographics
NPI:1548899388
Name:LANGFORD, STEPHANIE ELIZABETH
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ELIZABETH
Last Name:LANGFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 CASSELBERRY DR
Mailing Address - Street 2:
Mailing Address - City:LAKE WALES
Mailing Address - State:FL
Mailing Address - Zip Code:33853-5006
Mailing Address - Country:US
Mailing Address - Phone:317-900-2161
Mailing Address - Fax:
Practice Address - Street 1:824 CASSELBERRY DR
Practice Address - Street 2:
Practice Address - City:LAKE WALES
Practice Address - State:FL
Practice Address - Zip Code:33853-5006
Practice Address - Country:US
Practice Address - Phone:317-900-2161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-03
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator