Individual
MRS. DEBRA E LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
2520 VALLEY DR, POINT PLEASANT, WV 25550-2031
(304) 675-4340
Mailing address
2520 VALLEY DR, POINT PLEASANT, WV 25550-2031
(304) 675-4340
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0152383000
—
WV
Enumeration date
08/30/2007
Last updated
08/30/2007
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