| NPI | 1316081706 |
|---|---|
| Other Name | JAVEL JACKSON LONG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA 002284) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: GA 002009) |
| Enumeration Date | 2007-02-18 |
| Last Update Date | 2007-07-09 |