Individual
KRISTINE LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1105 N ANKENY BLVD STE 100, ANKENY, IA 50023-4003
(515) 255-8399
Mailing address
2812 50TH ST, DES MOINES, IA 50310-2561
(515) 720-1284
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
110508
IA
Other
Enumeration date
04/28/2022
Last updated
04/28/2022
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