Provider Demographics
NPI:1013427020
Name:LANGLEY, ALISHA LYNN
Entity Type:Individual
Prefix:
First Name:ALISHA
Middle Name:LYNN
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 1:402 EAGLE EDGE
Mailing Address - Street 2:
Mailing Address - City:DUENWEG
Mailing Address - State:MO
Mailing Address - Zip Code:64841-1095
Mailing Address - Country:US
Mailing Address - Phone:417-259-3325
Mailing Address - Fax:
Practice Address - Street 1:3901 E 32ND ST
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-3312
Practice Address - Country:US
Practice Address - Phone:417-347-7073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-04
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017044144101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health