person
Mr. Darian Wade Long I
Peer Specialist in Kennett, Missouri
NPI 1912303405

Darian Wade Long I is a Peer Specialist based in Kennett, MO. Darian Wade Long I practices in Kennett, MO. The NPI Number for Darian Wade Long I is 1912303405 and holds a License No. 8162 (Missouri).

The current practice location address for Darian Wade Long I is 925 Highway Vv, Kennett, MO and can be reached out via phone at 573-888-5925 and via fax at 573-888-9365. You can also correspond with Darian Wade Long I through the mailing address at 925 HIGHWAY VV, KENNETT, MO - 63857-0071 (mailing address contact number: ).

Location: 925 Highway Vv, Kennett, MO, 63857-0071
person
Provider Profile Details
NPI Number
1912303405
Provider Name
Darian Wade Long I
Credential
Provider Entity Type
Individual
Gender
Male
Address
925 Highway Vv, Kennett, MO, 63857-0071
Phone Number
573-888-5925
Fax Number
573-888-9365
Provider Enumeration Date
11/10/2014
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
925 Highway Vv
City
State
Zip
63857
Phone Number
573-888-5925
Fax Number
573-888-9365
person
Provider Business Mailing Address Details
Address
925 Highway Vv
City
State
Zip
63857
Phone Number
573-888-5925
Fax Number
573-888-9365
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
License No.
8162 (Missouri)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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