Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jackie Long, MSCCC-SLP

Individual provider Speech-Language Pathologist · NPI 1689405524

Jackie Long, MSCCC-SLP is a Speech-Language Pathologist in Farmington, New Mexico. Practices as a sole proprietor. Licensed in New Mexico.

Licensed in
NM
In the registry since
2024

Practice location Address checks out

3401 E 30th St
Farmington, NM 87402-8805
Phone: (505) 599-8617
Fax: (855) 290-2205
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence SAH-2024-0179 (NM)

Record details

NPI number1689405524
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSCCC-SLP
Sole proprietorYes
NPI enumeratedAugust 12, 2024
Last updated in NPPESAugust 12, 2024
Certification dateAugust 12, 2024
Mailing address4623 Balboa Park Loop, Bradenton, FL 34211-4962

Other providers in Farmington