Individual
JENNIFER L LONG-KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
603 E MILL ST, ROCK PORT, MO 64482-1725
(660) 744-5888
Mailing address
603 E MILL ST, ROCK PORT, MO 64482-1725
(660) 744-5888
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2001003593
MO
Other
Enumeration date
08/06/2009
Last updated
08/06/2009
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