Individual
RAEDAWN M LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
116 N 45TH ST, LOUISVILLE, KY 40212-2618
(502) 855-1927
Mailing address
116 N 45TH ST, LOUISVILLE, KY 40212-2618
(502) 855-1927
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
10/12/2018
Last updated
10/12/2018
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