Provider Demographics
NPI:1639627995
Name:LANGSTAFF, JODIE (OTRL)
Entity Type:Individual
Prefix:
First Name:JODIE
Middle Name:
Last Name:LANGSTAFF
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7373 W FLORIDA AVE APT 2A
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80232-5448
Mailing Address - Country:US
Mailing Address - Phone:906-430-7695
Mailing Address - Fax:
Practice Address - Street 1:1829 DENVER WEST DR # 27
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-3120
Practice Address - Country:US
Practice Address - Phone:303-982-6500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-15
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0005499225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty