Provider Demographics
NPI:1700334349
Name:LANGDON, BROOKE (MA)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:LANGDON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20000 MITCHELL PL UNIT 75
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80249-7232
Mailing Address - Country:US
Mailing Address - Phone:785-424-0413
Mailing Address - Fax:
Practice Address - Street 1:20000 MITCHELL PL UNIT 75
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80249-7232
Practice Address - Country:US
Practice Address - Phone:785-424-0413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-12
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor