Individual
MISS JACKIE D. LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
390 NE MIDWAY BLVD, #B-101, OAK HARBOR, WA 98277-2642
(360) 679-4211
(360) 279-2545
Mailing address
390 NE MIDWAY BLVD, #B-101, OAK HARBOR, WA 98277-2642
(360) 679-4211
(360) 279-2545
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL00003493
WA
Other
Enumeration date
07/24/2006
Last updated
07/08/2007
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