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General NPI Number Information
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NPI Number | 1902802960
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Entity Type | Individual
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Provider Name | MARY A. LANGUIRAND PH. D.
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Gender | Female
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Dates
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Enumeration Date | 06/23/2005
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Last Update Date | 08/04/2009
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Provider Practice Location Address
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Address Line | 821 FRANKLIN AVE SUITE 202
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City | GARDEN CITY
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State | NY
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Zip | 11530-4519
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Country | US
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Telephone | 516-294-2790
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Fax | 516-294-2791
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Provider Business Mailing Address
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Address Line | 190 CHOIR LN
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City | WESTBURY
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State | NY
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Zip | 11590-5733
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Country | US
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Telephone | 516-279-7406
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 002343
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 011208
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS-005601-L
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License Number State | PA
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