Individual
JESSICA LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
280 MERRIMACK ST STE 400, LAWRENCE, MA 01843-1787
(978) 946-1200
Mailing address
280 MERRIMACK ST STE 400, LAWRENCE, MA 01843-1787
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
224387
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042545136
—
MA
Enumeration date
04/02/2019
Last updated
04/02/2019
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