| NPI | 1619433125 |
|---|---|
| Former Name | KACEY ALEXANDRA LANGENDORF |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2018088779) |
| Enumeration Date | 2019-02-20 |
| Last Update Date | 2022-06-27 |