Individual
MARY A LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
935 STATE ROUTE VV, KENNETT, MO 63857-3822
(573) 559-2380
Mailing address
935 STATE ROUTE VV, KENNETT, MO 63857-3822
(573) 559-2380
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/17/2026
Last updated
06/17/2026
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