Healthcare Provider Details

I. General information

NPI: 1316665128
Provider Name (Legal Business Name): KENZIE LANGFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2022
Last Update Date: 08/17/2022
Certification Date: 08/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8121 NATIONAL AVE STE 401
MIDWEST CITY OK
73110-7572
US

IV. Provider business mailing address

5621 NW 82ND ST
OKLAHOMA CITY OK
73132-4907
US

V. Phone/Fax

Practice location:
  • Phone: 405-733-5437
  • Fax:
Mailing address:
  • Phone: 405-513-3874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: