Individual
MRS. JAMI LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
4180 SAGE BLUFF CROSSIN, FORT WAYNE, IN 46804
(260) 443-7300
(260) 482-5005
Mailing address
4180 SAGE BLUFF CROSSIN, FORT WAYNE, IN 46804
(260) 443-7300
(260) 482-5005
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001151A
IN
Other
Enumeration date
01/09/2015
Last updated
01/09/2015
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