Individual
JACQUELINE JOYCE LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
214 FERREL ST, PLATTE CITY, MO 64079-9511
(816) 469-5162
Mailing address
2414 CEDAR ST, HIGGINSVILLE, MO 64037-1607
(816) 810-0935
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/28/2021
Last updated
04/28/2021
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