Individual
MARCIA NICOLE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW,LCSW
Contact information
Practice address
10018 KENNERLY RD, SAINT LOUIS, MO 63128-2106
(314) 525-4404
Mailing address
10018 KENNERLY RD, SAINT LOUIS, MO 63128-2106
(314) 525-4404
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2011004950
MO
Other
Enumeration date
11/29/2011
Last updated
11/29/2011
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