Individual
DR. AIXA L LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
601 WEBSTER ST, WILDWOOD, FL 34785-3828
(813) 784-7340
(813) 200-1403
Mailing address
9807 PEPPER TREE PLACE, WILDWOOD, FL 34785
(813) 784-7340
(813) 200-1403
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY9560
FL
Other
Enumeration date
10/17/2016
Last updated
08/15/2022
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