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Individual

MS. BARBARA MAE LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DEVELOPMENTAL THERAP

Contact information

Practice address
634 E ASH ST, CANTON, IL 61520-2016
(309) 647-9744
(309) 647-4394
Mailing address
1148 S MAIN ST, CANTON, IL 61520-3426
(309) 647-9744
(309) 647-4394

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary

Other

Enumeration date
04/12/2007
Last updated
07/08/2007
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