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Individual

MRS. KRISTEN SAMARA LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.A., CCC-SLP

Contact information

Practice address
621 W 21ST ST, ANDOVER, KS 67002-8498
(316) 733-1349
(316) 733-5883
Mailing address
8424 W MYSTIC LAKES SOUTH ST, MAIZE, KS 67101-8602
(316) 722-7565

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1767
KS

Other

Enumeration date
02/27/2007
Last updated
07/08/2007
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