Individual
REBECCA LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
2705 ENLOE ST, HUDSON, WI 54016-8173
(651) 239-7576
Mailing address
125 BAYBERRY CT, HUDSON, WI 54016-7746
(651) 239-7576
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
105843
MN
225X00000X
Occupational Therapist
Primary
8032-26
WI
Other
Enumeration date
03/23/2019
Last updated
02/08/2023
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