| NPI | 1942697099 |
|---|---|
| Former Name | NANCY ANN LONG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0701007394) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KS 2735) |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2025-01-16 |