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1841861085
MAXINE LONG
COLUMBUS, MS
NPI
1841861085
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Additional Taxonomies
101YP2500X Counselor, Professional
Enumeration Date
2021-07-08
Last Update Date
2021-07-16
Business Address
MAXINE LONG
2623 5TH ST N
COLUMBUS, MS 39705-2009
Phone number: 662-241-7097
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Mailing Address
MAXINE LONG
2623 5TH ST N
COLUMBUS, MS 39705-2009
Phone number: 662-241-7097
Copy
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