MEDICARE: JESSICA RAI LANGSTON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist		AR

General Provider Information

NPI Number	:	1871422451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA RAI LANGSTON

Provider Business Mailing Address
First Line	:	4131 JOHN F KENNEDY BLVD STE C
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72116-8264
Country	:	US
Telephone Number	:	501-502-5420
Fax Number	:	501-557-3657

Provider Business Practice Location Address
First Line	:	4001 W 65TH ST STE E6
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72209-8560
Country	:	US
Telephone Number	:	501-502-5420
Fax Number	:	501-200-1103

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2026
Last Update Date	:	05/18/2026

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Directions to “ JESSICA RAI LANGSTON ” Practice Location

Language	Start Address	Practice Location

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