Individual
DONNA ANN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
913 LEVESQUE AVE E, WYNNE, AR 72396-3018
(870) 945-1718
(870) 208-8255
Mailing address
913 LEVESQUE AVE E, WYNNE, AR 72396-3018
(870) 945-1718
(870) 208-8255
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
O-T1308
AR
Other
Enumeration date
05/08/2013
Last updated
05/08/2013
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