Individual
MRS. JUDY LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
713 6TH ST, LAS VEGAS, NM 87701-4359
(505) 425-6126
(505) 425-6236
Mailing address
713 6TH ST, LAS VEGAS, NM 87701-4359
(505) 425-6126
(505) 425-6236
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I0111
NM
Other
Enumeration date
08/09/2006
Last updated
07/08/2007
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