Individual
KATELYN THERESA LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14733 CLAYTON RD, BALLWIN, MO 63011-2660
(314) 399-7732
Mailing address
3048 S CLIFTON AVE STE 112, SPRINGFIELD, MO 65807-6045
(573) 433-4310
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
2024034597
MO
106S00000X
Behavior Technician
Primary
RBT-22-214339
MO
Other
Enumeration date
02/01/2024
Last updated
06/11/2025
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