Individual
JAIME ELLEN LANGFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20 VANDERHOOF AVE, ROCKAWAY, NJ 07866-3148
(973) 586-5243
Mailing address
20 VANDERHOOF AVE, ROCKAWAY, NJ 07866-3148
(973) 586-5243
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC05607500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00745088
AGENCY MEDICAID MMIS #
NY
01
—
1003991019
AGENCY NPI #
NY
Enumeration date
10/19/2010
Last updated
08/31/2015
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