Individual
JENNIFFER A LONGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
410 WINDWARD WAY, KALISPELL, MT 59901
(406) 751-8331
Mailing address
410 WINDWARD WAY, KALISPELL, MT 59901-2680
(406) 751-8331
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
1041C0700X
Clinical Social Worker
37207
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A3419
STATE OF OREGON STATE BOARD OF LICENSED SOCIAL WORKERS
OR
Enumeration date
07/04/2012
Last updated
03/11/2019
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