Doctor Name: | MRS. JESSLYN PEARSON LANGBEIN |
NPI Number: | 1184071243 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PLPC, CFLE |
License Number: | PLC6408 |
Business Practice Address: | 115 Wilson St Deridder, LA - 706343823 |
Business Phone Number: | 3374634020 |
Business Fax Number: | |
Mailing Address: | 126 Sunset Ln, DERIDDER |
State: | LA |
Postal Code: | 706346019 |
Phone Number: | 3373969432 |
Fax Number: | |
NPI Enumeration Date: | 05/18/2016 |
NPI Last Update Date: | 05/18/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | PLC6408 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |