| Doctor Name: | MARY BETH LONGO |
| NPI Number: | 1326274226 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNS |
| License Number: | RN 194383 |
| Business Practice Address: | 12300 Mccracken Rd Suite 137 Garfield Hts, OH - 441252914 |
| Business Phone Number: | 2165876727 |
| Business Fax Number: | 2165876726 |
| Mailing Address: | 12300 Mccracken Rd, Suite 137 GARFIELD HTS |
| State: | OH |
| Postal Code: | 441252914 |
| Phone Number: | 2165876727 |
| Fax Number: | 2165876726 |
| NPI Enumeration Date: | 06/05/2009 |
| NPI Last Update Date: | 09/07/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SP0809X |
| License Number: | RN 194383 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Psych/Mental Health, Adult |
| Taxonomy Definition: | |