Individual
VIRGINIA LYNN LONGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
139 SOUTH ST, GRANBY, MA 01033-9547
(413) 887-1963
Mailing address
139 SOUTH ST, GRANBY, MA 01033-9547
(413) 887-1963
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
12514
MA
225XP0200X
Pediatric Occupational Therapist
12514
MA
Other
Enumeration date
01/31/2018
Last updated
11/30/2020
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