Individual
KAITLYN LANGOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
29600 S WIXOM RD, WIXOM, MI 48393-3459
(248) 960-1600
(248) 960-9755
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201009586
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17217
CA OT LICENSE
CA
Enumeration date
04/23/2019
Last updated
10/29/2024
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