Individual
DONNA LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
4202 OKEECHOBEE RD, FORT PIERCE, FL 34947-5414
(772) 462-6636
(772) 462-6635
Mailing address
4202 OKEECHOBEE RD, FORT PIERCE, FL 34947-5414
(772) 462-6636
(772) 462-6635
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA5860
FL
Other
Enumeration date
11/20/2008
Last updated
11/20/2008
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