Provider Demographics
NPI:1992073050
Name:LANGILLE-HOPPE, MARY MARGUERITE (PSYD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:MARGUERITE
Last Name:LANGILLE-HOPPE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:318 N BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74801-6920
Mailing Address - Country:US
Mailing Address - Phone:405-698-0628
Mailing Address - Fax:918-512-4741
Practice Address - Street 1:318 N BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74801-6920
Practice Address - Country:US
Practice Address - Phone:405-698-0628
Practice Address - Fax:918-512-4741
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-05
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1182103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical