Provider Demographics
NPI:1457588048
Name:LANGFORD, HEATHER DENISE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:DENISE
Last Name:LANGFORD
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 WINANS WAY
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-1435
Mailing Address - Country:US
Mailing Address - Phone:410-945-4336
Mailing Address - Fax:
Practice Address - Street 1:600 RIDGELY AVE
Practice Address - Street 2:SUITE 230
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1001
Practice Address - Country:US
Practice Address - Phone:301-919-7727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-22
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04072235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist