| Doctor Name: | MARY LEE LONG |
| NPI Number: | 1073772349 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSN,CRNP |
| License Number: | SP007432 |
| Business Practice Address: | 1645 Rostraver Rd Belle Vernon, PA - 150129655 |
| Business Phone Number: | 7242430950 |
| Business Fax Number: | 7242430952 |
| Mailing Address: | 1645 Rostraver Rd, BELLE VERNON |
| State: | PA |
| Postal Code: | 150129655 |
| Phone Number: | 7242430950 |
| Fax Number: | 7242430952 |
| NPI Enumeration Date: | 06/03/2008 |
| NPI Last Update Date: | 06/03/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | SP007432 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |