Individual
JAIME REBEKAH LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 S FAIRVIEW AVE, PARK RIDGE, IL 60068-4712
(847) 653-3649
Mailing address
1001 S FAIRVIEW AVE, PARK RIDGE, IL 60068-4712
(847) 653-3649
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
1122109
IL
Other
Enumeration date
01/16/2019
Last updated
01/16/2019
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