Individual
RODNEY LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1300 MELODY LN, LEAKESVILLE, MS 39451-6530
(601) 394-2331
Mailing address
1300 MELODY LN, LEAKESVILLE, MS 39451-6530
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
10449
NC
235Z00000X
Speech-Language Pathologist
3444
AL
235Z00000X
Speech-Language Pathologist
3843-154
WI
235Z00000X
Speech-Language Pathologist
Primary
S2476
MS
235Z00000X
Speech-Language Pathologist
SL011342
PA
235Z00000X
Speech-Language Pathologist
SLP008471
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10449
NORTH CAROLINA SPEECH THERAPY LICENSE
NC
01
—
3444
AL SPEECH THERAPY LICENSE
AL
01
—
3843-154
WI SPEECH THERAPY LICENSE
WI
01
—
S2476
MS SPEECH THERAPY LICENSE
MS
01
—
SL011342
PA SPEECH THERAPY LICENSE
PA
01
—
SLP008471
GEORGIA SPEECH THERAPY LICENSE
GA
Enumeration date
12/13/2016
Last updated
12/13/2016
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