Individual
JENNIFER ANN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LADC
Contact information
Practice address
1351 FROST AVENUE, SENIOR RECOVERY PROGRAM, ST. PAUL, MN 55109
(651) 773-0473
(651) 773-9298
Mailing address
1351 FROST AVENUE, SENIOR RECOVERY PROGRAM, ST. PAUL, MN 55109
(651) 773-0473
(651) 773-9298
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
301686
MN
Other
Enumeration date
12/03/2008
Last updated
07/16/2009
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