Individual
TIFFANY LYNN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
807 DONNELL BLVD STE Q, DALEVILLE, AL 36322-2111
(334) 709-4024
Mailing address
180 DON CIR, OZARK, AL 36360-1311
(205) 337-3973
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-288317
AL
Other
Enumeration date
09/11/2023
Last updated
09/11/2023
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