Individual
CONNIE MORTENSEN LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
15779 OKAPI ST NW, RAMSEY, MN 55303-3878
(763) 323-9511
Mailing address
15779 OKAPI ST NW, RAMSEY, MN 55303-3878
(763) 323-9511
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3524
MN
Other
Enumeration date
12/30/2008
Last updated
12/30/2008
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