Individual
KRYSTAL LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1313 NEW YORK AVE NW, WASHINGTON, DC 20005-4701
(240) 338-8052
Mailing address
1313 NEW YORK AVE NW, WASHINGTON, DC 20005-4701
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
03/15/2023
Last updated
11/05/2024
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