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1497006050
DIANE M LONGO
ST AUGUSTINE, FL
NPI
1497006050
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: FL SW10907)
Enumeration Date
2012-09-24
Last Update Date
2012-09-24
Business Address
-- DIANE M LONGO LCSW
620 21ST ST
ST AUGUSTINE, FL 32084-1706
Phone number: 904-825-8091
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Mailing Address
-- DIANE M LONGO LCSW
620 21ST ST
ST AUGUSTINE, FL 32084-1706
Phone number: 904-825-8091
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