Long, Kai Jeanine

Long, Kai Jeanine is an individual health care provider with primary practice located at 190 Southpark Blvd Suite 100, St Augustine FL 32086-4120. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Long, Kai Jeanine can be contacted via phone (904) 824-1478.

Contact Information

Primary practice address
190 Southpark Blvd Suite 100 St Augustine FL 32086-4120
Phone: (904) 824-1478
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SA8605 Florida

Profile Details

NPI number 1063552404
LBN Legal business name Long, Kai Jeanine
Credentials Master of Arts (MA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 7th, 2007
Last updated May 1st, 2008 - about 16 years 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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Identifiers

StateTypeNumberIssuer
All States NPI 1063552404 NPPES
Florida MEDICAID 891547400

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