Individual
VAKENDALL V LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
951 COURT AVE, MEMPHIS, TN 38103-2813
(901) 567-3554
(901) 567-3559
Mailing address
2220 UNION AVE, MEMPHIS, TN 38104-4315
(901) 567-3554
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6501
TN
Other
Enumeration date
03/20/2018
Last updated
03/20/2018
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