Provider Demographics
NPI:1639533292
Name:LANGLEY, KIMBERLY LINN
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:LINN
Last Name:LANGLEY
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 1:3077 CASA DEL SOL CIR
Mailing Address - Street 2:#206
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-4300
Mailing Address - Country:US
Mailing Address - Phone:281-881-9734
Mailing Address - Fax:
Practice Address - Street 1:3077 CASA DEL SOL CIR
Practice Address - Street 2:#206
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-4300
Practice Address - Country:US
Practice Address - Phone:281-881-9734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-11
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker