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General NPI Number Information
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NPI Number | 1619303054
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Entity Type | Individual
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Provider Name | NICOLE ASHLEY LANGTON CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 09/17/2013
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Last Update Date | 09/17/2013
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Provider Practice Location Address
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Address Line | 8115 E INDIAN BEND RD SUITE 123
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City | SCOTTSDALE
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State | AZ
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Zip | 85250-4819
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Country | US
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Telephone | 480-951-6451
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Fax |
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Provider Business Mailing Address
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Address Line | 4644 N 22ND ST UNIT 2091
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City | PHOENIX
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State | AZ
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Zip | 85016-4617
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Country | US
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Telephone | 631-241-2517
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SLP6963
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License Number State | AZ
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