Organization
DR. AIXA LONG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AIXA LONG PSY.D (OWNER)
(813) 784-7340
Entity
Organization
Contact information
Practice address
601 WEBSTER ST, WILDWOOD, FL 34785-3828
(352) 432-8892
Mailing address
9807 PEPPER TREE PLACE, WILDWOOD, FL 34785
(813) 784-7340
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
08/24/2022
Last updated
08/24/2022
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