Individual
STEPHANIE LAUREN LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
409 PARK AVE, ADAMSVILLE, TN 38310-2461
(731) 632-3301
Mailing address
1005 THOMPSON SCHOOL RD, HUNTINGDON, TN 38344-5974
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
06/27/2018
Last updated
06/27/2018
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