| Doctor Name: | MARYANN KUZIO LONGWELL |
| NPI Number: | 1053455352 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S.W. |
| License Number: | 1159 |
| Business Practice Address: | 1548 G St 2a Salida, CO - 812012645 |
| Business Phone Number: | 7193294810 |
| Business Fax Number: | |
| Mailing Address: | 1133 E. Ouray Ave., Po Box 627 PONCHA SPRINGS |
| State: | CO |
| Postal Code: | 812420627 |
| Phone Number: | 7193294810 |
| Fax Number: | |
| NPI Enumeration Date: | 02/19/2007 |
| NPI Last Update Date: | 06/01/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 1159 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |