Individual
MRS. JEANINE LANGENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
726 W. AIRE LIBRE AVE, PHOENIX, AZ 85023-7910
(602) 938-9839
(602) 938-9839
Mailing address
726 W. AIRE LIBRE AVE, PHOENIX, AZ 85023-7910
(602) 938-9839
(602) 938-9839
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1829
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007171346
AETNA
AZ
05
—
348509
—
AZ
01
—
AZ0460200
BCBS
AZ
Enumeration date
08/26/2005
Last updated
11/06/2008
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