Individual
TIA JEAN LANGLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1016 BLACKTHORN CV, FORT WAYNE, IN 46804-3551
(989) 388-1354
Mailing address
1016 BLACKTHORN CV, FORT WAYNE, IN 46804-3551
(989) 388-1354
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
07/03/2023
Last updated
07/03/2023
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