Long, Ajasha Maxine
Long, Ajasha Maxine is an individual health care provider with primary practice located at 14540 Old Saint Augustine Rd Ste 2591 , Jacksonville FL 32258-7420. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counseling, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Long, Ajasha Maxine can be contacted via phone (904) 376-3800.Contact Information
Primary practice address
14540 Old Saint Augustine Rd Ste 2591
Jacksonville FL 32258-7420
Phone: (904) 376-3800
Fax: (904) 390-7405
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Counseling | 103TC1900X | P.08309 | Ohio |
Behavioral Health & Social Service Providers / Psychologist | 103T00000X | PY12271 | Florida |
Profile Details
NPI number | 1609495282 |
---|---|
LBN Legal business name | Long, Ajasha Maxine |
Credentials | PHD |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Apr 13th, 2020 |
Last updated | Jun 3rd, 2024 - about 6 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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