JACOB LONG

ALTON, IL
NPI1295138303
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2014-10-02
Last Update Date2014-10-02
Business Address
-- JACOB LONG
2615 EDWARDS ST
ALTON, IL 62002-3915
Phone number: 618-462-2331
Mailing Address
-- JACOB LONG
2615 EDWARDS ST
ALTON, IL 62002-3915
Phone number: 618-462-2331
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