Provider Demographics
NPI:1598107633
Name:LANGDON, ANASTASIA MARIE (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ANASTASIA
Middle Name:MARIE
Last Name:LANGDON
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MS
Other - First Name:ANASTASIA
Other - Middle Name:MARIE
Other - Last Name:LOANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2652 EMMA CIR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-7539
Mailing Address - Country:US
Mailing Address - Phone:309-219-5532
Mailing Address - Fax:
Practice Address - Street 1:2901 FOXMOOR DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:IL
Practice Address - Zip Code:60538-4092
Practice Address - Country:US
Practice Address - Phone:630-897-1961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-17
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146011642235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist