Provider Demographics
NPI:1710695622
Name:LANGDON, SUMMER R
Entity Type:Individual
Prefix:MRS
First Name:SUMMER
Middle Name:R
Last Name:LANGDON
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 1:160 DIVISION ST STE A
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-2914
Mailing Address - Country:US
Mailing Address - Phone:517-320-0418
Mailing Address - Fax:
Practice Address - Street 1:160 DIVISION ST STE A
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-2914
Practice Address - Country:US
Practice Address - Phone:517-320-0418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician