JACKIE LONG

HARTFORD, CT
NPI1801470026
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: CT  076925)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
(Licence: CT  076925)
Enumeration Date2021-05-12
Last Update Date2024-04-23
Business Address
JACKIE LONG MD
200 RETREAT AVE
HARTFORD, CT 06106-3309
Phone number: 860-545-7200
Mailing Address
JACKIE LONG MD
200 RETREAT AVE
HARTFORD, CT 06106-3309
Phone number: 860-545-7200