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Individual

KATRINA LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
900 E MAIN ST, MEDFORD, OR 97504-7136
(541) 842-7705
(541) 842-7640
Mailing address
24 S SHASTA AVE, EAGLE POINT, OR 97524-8640
(541) 621-1829

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1041C0700X
Clinical Social Worker
Primary
6384
OR

Other

Enumeration date
08/09/2011
Last updated
01/31/2025
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