Individual
MASAKO LONGWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8119 HOLLAND RD, ALEXANDRIA, VA 22306-3135
(571) 234-0403
Mailing address
8119 HOLLAND RD, ALEXANDRIA, VA 22306-3135
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024189206
VA
Other
Enumeration date
10/19/2023
Last updated
04/05/2024
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