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1154423937
KELLY ANNE LONG
BLOOMINGTON, IL
NPI
1154423937
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
104100000X Social Worker
Enumeration Date
2006-09-02
Last Update Date
2007-07-08
Business Address
-- KELLY ANNE LONG
108 W MARKET ST
BLOOMINGTON, IL 61701-3918
Phone number: 309-827-5351
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Mailing Address
-- KELLY ANNE LONG
913 CHIPPEWA ST
NORMAL, IL 61761-5758
Phone number: 309-530-5884
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