Individual
ANNETTE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
924 INDIANA AVE, PUEBLO, CO 81004-3747
(719) 564-9039
(719) 561-8752
Mailing address
924 INDIANA AVE, PUEBLO, CO 81004-3747
(719) 564-9039
(719) 561-8752
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
676
CO
Other
Enumeration date
07/24/2006
Last updated
07/08/2007
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