Provider Demographics
NPI:1083964209
Name:LANGSTON, LATREECE LASHUN
Entity Type:Individual
Prefix:
First Name:LATREECE
Middle Name:LASHUN
Last Name:LANGSTON
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 1:6212 CANYON DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73105-6416
Mailing Address - Country:US
Mailing Address - Phone:405-767-6209
Mailing Address - Fax:
Practice Address - Street 1:6212 CANYON DR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73105-6416
Practice Address - Country:US
Practice Address - Phone:405-767-6209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional