Individual
IMANI LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4141 S NOGALES ST, WEST COVINA, CA 91792-3056
(833) 831-8946
Mailing address
13462 FIRESTONE ST, HESPERIA, CA 92344-9416
(442) 433-7185
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103TF0000X
Family Psychologist
Primary
—
—
103TS0200X
School Psychologist
—
—
Other
Enumeration date
01/31/2024
Last updated
01/31/2024
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