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Individual
MRS. LORETTE MARIE LONG
Active
Individual
MRS. LORETTE MARIE LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PCC-S LICDC BCPC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
965570
OH
101YM0800X
Mental Health Counselor
A11029
OH
101YP2500X
Professional Counselor
E3139
OH
Other
Enumeration date
07/31/2006
Last updated
05/16/2022
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