Provider Demographics
NPI:1205584356
Name:LANGTON, CAITLIN ELIZA
Entity type:Individual
Prefix:MRS
First Name:CAITLIN
Middle Name:ELIZA
Last Name:LANGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:CAITLIN
Other - Middle Name:ELIZA
Other - Last Name:WILKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:322 BAY ST STE 4
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-2489
Mailing Address - Country:US
Mailing Address - Phone:231-268-0007
Mailing Address - Fax:
Practice Address - Street 1:5781 HOWARD RD
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-8870
Practice Address - Country:US
Practice Address - Phone:586-215-0199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Single Specialty