Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003118423 |
---|---|
Provider Name | Mrs. Leigh Ann Long |
First Address | Nashville, TN 37217-3841 |
Second Address | Nashville, TN 37217-3841 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2010 |
Last Update Date | 05/11/2012 |