Individual
MRS. JEANNE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
619 19TH STREET SOUTH, BIRMINGHAM, AL 35233
(205) 934-6600
Mailing address
619 19TH STREET SOUTH, BIRMINGHAM, AL 35233
(205) 934-6600
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1769
AL
225XH1200X
Hand Occupational Therapist
1769
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
515-10368
BLUE CROSS
AL
Enumeration date
08/30/2006
Last updated
04/09/2019
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