Individual
JACQUELINE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
265 HACKENSACK ST UNIT 1489, WOOD RIDGE, NJ 07075-1253
(332) 203-7377
Mailing address
166 HILLSIDE AVE, RIVER EDGE, NJ 07661-2308
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS01295800
NJ
Other
Enumeration date
10/06/2025
Last updated
10/06/2025
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