Individual
KIM MARIE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
300 W 9TH ST, FREDERICK, MD 21701-4541
(667) 600-3310
(301) 694-8221
Mailing address
300 W 9TH ST, FREDERICK, MD 21701-4541
(667) 600-3310
(301) 694-8221
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC0743
MD
Other
Enumeration date
12/04/2018
Last updated
12/04/2018
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