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Individual

MRS. KRISTEN L LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC, CACII

Contact information

Practice address
84 ACOMA BLVD N STE 104, LAKE HAVASU CITY, AZ 86403-6096
(928) 733-5101
(970) 249-2955
Mailing address
84 ACOMA BLVD N STE 104, LAKE HAVASU CITY, AZ 86403-6096
(928) 733-5101
(970) 249-2955

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-16476
AZ

Other

Enumeration date
03/14/2012
Last updated
12/12/2022
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