Healthcare Provider Details

I. General information

NPI: 1346460136
Provider Name (Legal Business Name): DEE LANGFORD EDD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

735 E 10TH ST
CHATTANOOGA TN
37403-2917
US

IV. Provider business mailing address

6727 HERITAGE BUSINESS CT SUITE 712
CHATTANOOGA TN
37421-7015
US

V. Phone/Fax

Practice location:
  • Phone: 423-510-9504
  • Fax: 423-510-9548
Mailing address:
  • Phone: 423-510-9505
  • Fax: 423-510-9548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License Number5963792
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: