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Individual

MISS JAMIE L LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
504 MICAH DR, DRAWER M, OLNEY, IL 62450-4720
(618) 395-4306
(618) 395-4507
Mailing address
602 E 5TH ST, MOUNT CARMEL, IL 62863-2152
(618) 262-7473
(618) 263-6579

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
01/05/2010
Last updated
11/24/2010
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