Individual
KRISTIN ANN LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
124 HARVARD ST, BROOKLINE, MA 02446-6478
(610) 349-4202
Mailing address
13 EAGAN PL, PEABODY, MA 01960-5674
(610) 349-4202
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
10128
MA
103TC0700X
Clinical Psychologist
PS01422
RI
Other
Enumeration date
07/27/2017
Last updated
07/27/2017
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