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Individual

MS. JEANNE L LONGTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MACCC-SLP

Contact information

Practice address
555 N BRADLEY HWY, SUITE C, ROGERS CITY, MI 49779-1539
(989) 734-7545
(989) 734-7648
Mailing address
555 N BRADLEY HWY, SUITE C, ROGERS CITY, MI 49779-1539
(989) 734-7545
(989) 734-7648

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01138435
PROFESSIONAL ASHA NATIONAL LICENSE
Enumeration date
02/08/2011
Last updated
02/08/2011
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