Most Relevant Information
Provider Data
| NPI Number: | 1003550534 |
| Provider Name: | MAYA LONGINO |
| Entity Type: | Individual |
| Taxonomy Code: | 373H00000X |
| Specialty: | Day Training/Habilitation Specialist |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/21/2022 |
| Last Updated: | 04/21/2022 |
Provider Practice Location
2010 CHESTNUT ST
VAN BUREN
AR
729565321
Practice Location Phone/Fax
| Phone: | 4704719600 |
| Fax: | 4704307596 |
Provider Mailing Location
2010 CHESTNUT ST
VAN BUREN
AR
729565321
Provider Mailing Phone/Fax
| Phone: | 4704719600 |
| Fax: | 4704307596 |