Individual
TRACEY EILEEN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
337 LIVERMORE RD, BLAIRSVILLE, PA 15717-4121
(724) 762-8356
Mailing address
337 LIVERMORE RD, BLAIRSVILLE, PA 15717-4121
(724) 762-8356
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP006192
PA
Other
Enumeration date
07/27/2023
Last updated
07/27/2023
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