Provider Demographics
NPI:1861270241
Name:LANGEHENNIG, SHELBY DENISE
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:DENISE
Last Name:LANGEHENNIG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:897 COUNTY ROAD 2369
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:TX
Mailing Address - Zip Code:75436-3113
Mailing Address - Country:US
Mailing Address - Phone:903-495-5716
Mailing Address - Fax:
Practice Address - Street 1:2121 MIDWAY RD
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-5262
Practice Address - Country:US
Practice Address - Phone:979-851-1022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX121764235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist