| NPI | 1881196673 |
|---|---|
| Former Name | JESSICA L LONG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2018-03-07 |
| Last Update Date | 2025-08-28 |