Provider Demographics
NPI:1912022583
Name:LANGHAM, AMANDA HARRIS (AUD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:HARRIS
Last Name:LANGHAM
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3202 W ANDERSON LN
Mailing Address - Street 2:# 208
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-1035
Mailing Address - Country:US
Mailing Address - Phone:512-879-3993
Mailing Address - Fax:
Practice Address - Street 1:3202 W ANDERSON LN
Practice Address - Street 2:# 208
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-1035
Practice Address - Country:US
Practice Address - Phone:512-879-3993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX334302355S0801X
TX80309237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant