Individual
MS. GLORIA K. LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MACCC-SLP
Contact information
Practice address
3321 S 400 E, KOKOMO, IN 46902-9358
(765) 455-0206
Mailing address
3321 S 400 E, KOKOMO, IN 46902-9358
(765) 455-0206
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22001228
IN
Other
Enumeration date
06/01/2009
Last updated
06/01/2009
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