Individual
MARIAN MARLENE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPSS
Contact information
Practice address
501 MULBERRY ST, PURVIS, MS 39475-4380
(217) 766-7823
Mailing address
501 MULBERRY ST, PURVIS, MS 39475-4380
(217) 766-7823
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/03/2024
Last updated
06/03/2024
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