Individual
DR. JENNIFER SUZANNE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
408 WASHINGTON AVE, STE 107, WEST PLAINS, MO 65775-3404
(417) 255-8790
(417) 222-6991
Mailing address
408 WASHINGTON AVE, STE 107, WEST PLAINS, MO 65775-3404
(417) 255-8790
(417) 222-6991
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2010030531
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
497555003
—
MO
Enumeration date
08/31/2006
Last updated
06/28/2017
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