Healthcare Provider Details

I. General information

NPI: 1265875595
Provider Name (Legal Business Name): BRITTANY KAY LONG PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRITTANY K NEEF PSY.D.

II. Dates (important events)

Enumeration Date: 04/17/2013
Last Update Date: 09/09/2022
Certification Date: 09/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13375 UNIVERSITY AVE STE 201
CLIVE IA
50325-8260
US

IV. Provider business mailing address

13375 UNIVERSITY AVE STE 201
CLIVE IA
50325-8260
US

V. Phone/Fax

Practice location:
  • Phone: 515-823-0026
  • Fax:
Mailing address:
  • Phone: 515-823-0026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number081490
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number081827
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: