Provider Demographics
NPI:1346671211
Name:LANGFORD, NANCY (MED)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:
Last Name:LANGFORD
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7345 W SAND LAKE RD
Mailing Address - Street 2:SUITE 219
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-5284
Mailing Address - Country:US
Mailing Address - Phone:407-351-1010
Mailing Address - Fax:407-351-1087
Practice Address - Street 1:8654 VISTA PINE CT
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32836-6307
Practice Address - Country:US
Practice Address - Phone:407-351-1010
Practice Address - Fax:407-351-1087
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-03
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH2413101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH2413OtherLICENSE NUMBER