Individual
MISS JESSICA OWEN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
2434 S EASON BLVD, TUPELO, MS 38804-6942
(662) 844-1717
(662) 680-6416
Mailing address
261 COUNTY ROAD 1806, SALTILLO, MS 38866-9324
(662) 231-4359
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/12/2006
Last updated
07/08/2007
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