Lessie Ellen Long, CPS

NPI #1811471592 in Kennett, Missouri

Provider Information

NPI Number: 1811471592
Entity Type: Individual
Name: Lessie Ellen Long, CPS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Peer Specialist
Credential: CPS
Enumeration Date: Sep 19, 2018
Last Updated: Sep 19, 2018

Practice Location

Address: 925 HIGHWAY V V
City: Kennett
State: Missouri
ZIP Code: 63857-3866
Phone: (573) 359-2600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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