TIA JACQUELINE LONG

MADISON, WI
NPI1346686201
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy106H00000X Marriage & Family Therapist
Additional Taxonomies101YP2500X Counselor, Professional
Enumeration Date2013-05-20
Last Update Date2013-05-20
Business Address
-- TIA JACQUELINE LONG M.S.
6333 ODANA RD
MADISON, WI 53719-1170
Phone number: 608-270-2511
Mailing Address
-- TIA JACQUELINE LONG M.S.
607 4TH ST
BRODHEAD, WI 53520-1135
Phone number: