Individual
DR. KATHLEEN LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
508 GRAY RD, WINDHAM, ME 04062-4831
(252) 349-0219
Mailing address
PO BOX 6061, FALMOUTH, ME 04105-6061
(252) 349-0219
(252) 636-5677
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS1445
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0319V
BLUE CROSS BLUE SHIELD NC
NC
Enumeration date
02/21/2006
Last updated
05/30/2019
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