Individual
JAMIE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
3965 75TH ST, SUITE 104, AURORA, IL 60504-7925
(630) 236-7000
Mailing address
3965 75TH ST, SUITE 104, AURORA, IL 60504-7925
(630) 236-7000
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
056010370
IL
Other
Enumeration date
01/08/2014
Last updated
01/08/2014
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