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Individual
PATRICK LONG
Active
Individual
PATRICK LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
D7594251
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
97182299F55348
MEDICAL
CA
Enumeration date
03/01/2017
Last updated
03/01/2017
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