Individual
JENNIFER MARIE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
3171 N MERIDIAN ST, INDIANAPOLIS, IN 46208-4784
(317) 880-3024
Mailing address
3171 N MERIDIAN ST, INDIANAPOLIS, IN 46208-4784
(317) 880-3024
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39002792A
IN
Other
Enumeration date
11/12/2015
Last updated
11/12/2015
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