Individual
JENNIFER LONGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
608 S PINE ST, ALTOONA, PA 16602-5787
(717) 798-7159
Mailing address
608 S PINE ST, PO BOX 1625, ALTOONA, PA 16602-5787
(717) 798-7159
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL008087
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SL008087
LICENCE NUMBER
PA
Enumeration date
08/29/2006
Last updated
06/30/2009
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