| Kelly Ann Long, | |
|
5710 S 66th St, Cave Springs, AR 72718-8447 | |
| (479) 601-3537 | |
| Not Available |
| Full Name | Kelly Ann Long |
|---|---|
| Gender | Female |
| Speciality | Speech-language Pathologist |
| Location | 5710 S 66th St, Cave Springs, Arkansas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649906033 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | 506 (Arkansas) | Primary |
| Provider Name | Legacy Healthcare Services Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1023684370 PECOS PAC ID: 2163339722 Enrollment ID: O20210825003977 |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly Ann Long, 5710 S 66th St, Cave Springs, AR 72718-8447 Ph: (479) 601-3537 | Kelly Ann Long, 5710 S 66th St, Cave Springs, AR 72718-8447 Ph: (479) 601-3537 |
Ashley Elizabeth Nixon, MS, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1095 E Lowell Ave, Cave Springs, AR 72718 Phone: 469-260-9076 | |
Amanda Capps, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 516 E Lowell Ave, Cave Springs, AR 72718 Phone: 479-631-7678 | |
Mary Lee, MS, CCC-SLP Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 1276 S Main St, Cave Springs, AR 72718 Phone: 479-245-3515 |