Individual
PATRICIA JOANN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCMHC
Contact information
Practice address
257 MAIN STREET, HYDE PARK, VT 05655
(802) 793-7687
Mailing address
PO BOX 54, HYDE PARK, VT 05655-0054
(802) 793-7687
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
068 0000382
VT
Other
Enumeration date
01/26/2009
Last updated
01/26/2009
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