| Dr. Aixa Long | |
|
601 Webster St Wildwood FL 34785-3828 | |
| (352) 432-8892 | |
| Not Available |
| Full Name | Dr. Aixa Long |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 601 Webster St, Wildwood, Florida |
| Authorized Official Name and Position | Aixa Long (OWNER) |
| Authorized Official Contact | 8137847340 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Aixa Long 9807 Pepper Tree Place Wildwood FL 34785 Ph: (813) 784-7340 | Dr. Aixa Long 601 Webster St Wildwood FL 34785-3828 Ph: (352) 432-8892 |
| NPI Number | 1467171363 |
|---|---|
| Provider Enumeration Date | 08/24/2022 |
| Last Update Date | 08/24/2022 |
| Certification Date | 08/24/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467171363 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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