Individual
MRS. LAUREN MICHELLE LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
530 SPARKMAN ST SW, HARTSELLE, AL 35640-3120
(256) 585-5925
Mailing address
205 NESMITH RD, BLOUNTSVILLE, AL 35031-6717
(256) 585-5925
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3873
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
336814
—
AL
Enumeration date
02/05/2019
Last updated
02/05/2019
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