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Individual
MS. MICHELE SUZANNE LONG
Active
Individual
MS. MICHELE SUZANNE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, LMSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
064972-1
NY
163W00000X
Registered Nurse
Primary
614510-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02850677
—
NY
Enumeration date
06/02/2011
Last updated
06/02/2011
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