Individual
KELLY LONGWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1019 E WATER ST, ELMIRA, NY 14901-3332
(607) 733-5696
Mailing address
1019 E WATER ST, ELMIRA, NY 14901-3332
(607) 733-5696
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/19/2015
Last updated
05/19/2015
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