Individual
DANIELLE DENISE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5908 COBBLESTONE CREEK CIR, MABLETON, GA 30126-2654
(901) 574-1196
Mailing address
5908 COBBLESTONE CREEK CIR, MABLETON, GA 30126-2654
(901) 574-1196
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
05/09/2012
Last updated
11/26/2019
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