Provider Demographics
NPI:1205282191
Name:LANGLEY, KRIS (MS, MA)
Entity type:Individual
Prefix:
First Name:KRIS
Middle Name:
Last Name:LANGLEY
Suffix:
Gender:F
Credentials:MS, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36B HILLCREST RD
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-1222
Mailing Address - Country:US
Mailing Address - Phone:415-505-7212
Mailing Address - Fax:
Practice Address - Street 1:36B HILLCREST RD
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-1222
Practice Address - Country:US
Practice Address - Phone:415-505-7212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-10
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12636235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist