JACKIE LONG

FARMINGTON, NM
NPI1689405524
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: NM  SAH-2024-0179)
Enumeration Date2024-08-12
Last Update Date2024-08-12
Business Address
JACKIE LONG M.S. CCC-SLP
3401 E 30TH ST
FARMINGTON, NM 87402-8805
Phone number: 505-599-8617
Mailing Address
JACKIE LONG M.S. CCC-SLP
4623 BALBOA PARK LOOP
BRADENTON, FL 34211-4962
Phone number: 806-440-1663
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