Individual
MRS. AMANDA WEAVER LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1780 SUNFLOWER CIR, TUPELO, MS 38801-8193
(828) 273-3119
Mailing address
1780 SUNFLOWER CIR, TUPELO, MS 38801-8193
(828) 273-3119
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
07/15/2013
Last updated
07/30/2013
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