Individual
JENSEN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1109 FAYETTEVILLE RD, VAN BUREN, AR 72956-3363
(479) 474-6444
(479) 474-6446
Mailing address
12110 SYCAMORE ST, FORT SMITH, AR 72916-8408
(479) 926-1606
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/24/2023
Last updated
04/24/2023
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