Individual
ALI LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 E BLAZE RD, MOUNT VERNON, MO 65712-1805
(417) 466-7512
Mailing address
700 E CLEVELAND AVE, MONETT, MO 65708-1436
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2020025845
MO
Other
Enumeration date
09/09/2020
Last updated
09/09/2020
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