Individual
SHANNON M LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11081 COUNTY ROAD 3570, ADA, OK 74820-0606
(580) 279-9656
Mailing address
11081 COUNTY ROAD 3570, ADA, OK 74820-0606
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
—
OK
Other
Enumeration date
04/14/2022
Last updated
04/14/2022
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