KELLY ANNE LONG

BLOOMINGTON, IL
NPI1154423937
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker Clinical
(Licence: IL  149027456)
Enumeration Date2006-09-02
Last Update Date2025-03-18
Business Address
KELLY ANNE LONG
108 W MARKET ST
BLOOMINGTON, IL 61701-3918
Phone number: 309-827-5351
Mailing Address
KELLY ANNE LONG
913 CHIPPEWA ST
NORMAL, IL 61761-5758
Phone number: 309-530-5884
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