Individual
TODD ANDREW LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
301 S J T STITES ST, SALLISAW, OK 74955-9302
(918) 774-1413
Mailing address
301 S J T STITES ST, SALLISAW, OK 74955-9302
(918) 774-1413
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
11484
OK
Other
Enumeration date
12/08/2015
Last updated
05/07/2025
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