Individual
SANDRA LEE LANGSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1206 CLINTON RD, JACKSON, MI 49202-2005
(517) 783-4250
(517) 783-4164
Mailing address
1206 CLINTON RD, JACKSON, MI 49202-2005
(517) 783-4250
(517) 783-4164
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401005369
MI
Other
Enumeration date
10/09/2015
Last updated
10/09/2015
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