Provider Demographics
NPI:1952655698
Name:LANGEY, CARRIE A (SLP-CCC)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:A
Last Name:LANGEY
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 CENTER RD
Mailing Address - Street 2:PO BOX 220
Mailing Address - City:MORIAH
Mailing Address - State:NY
Mailing Address - Zip Code:12960
Mailing Address - Country:US
Mailing Address - Phone:518-546-3394
Mailing Address - Fax:
Practice Address - Street 1:2600 CENTER ROAD
Practice Address - Street 2:
Practice Address - City:MORIAH
Practice Address - State:NY
Practice Address - Zip Code:12960
Practice Address - Country:US
Practice Address - Phone:518-546-3394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-02
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011775235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY011775OtherSPEECH-LANGUAGE PATHOLOGIST