Individual
AMANDA LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPC-IT, NCC
Contact information
Practice address
342 N WATER ST STE 600, MILWAUKEE, WI 53202-5715
(414) 435-2981
Mailing address
342 N WATER ST STE 600, MILWAUKEE, WI 53202-5715
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/16/2020
Last updated
07/16/2020
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