MR. Darian Wade Long I

NPI #1912303405 in Kennett, Missouri

Provider Information

NPI Number: 1912303405
Entity Type: Individual
Name: MR. Darian Wade Long I
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Peer Specialist
Enumeration Date: Nov 10, 2014
Last Updated: Nov 10, 2014

Practice Location

Address: 925 HIGHWAY VV
City: Kennett
State: Missouri
ZIP Code: 63857
Phone: (573) 888-5925

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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