Individual
KRISTA LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12 UNSER BLVE SE, SUITE C, RIO RANCHO, NM 87124
(505) 636-6100
Mailing address
12 UNSER BLVE SE, SUITE C, RIO RANCHO, NM 87124
(505) 636-6100
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
INTERN
NM
101YM0800X
Mental Health Counselor
INTERN
NM
Other
Enumeration date
01/31/2025
Last updated
01/31/2025
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