Individual
JASMINE KIM LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15201 N CENTRAL AVE, PHOENIX, AZ 85022-3641
(602) 502-4397
Mailing address
14221 N 51ST AVE APT 1058, GLENDALE, AZ 85306-2541
(928) 273-9626
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SLPA11042
AZ
Other
Enumeration date
02/10/2020
Last updated
02/10/2020
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