Individual
ANGIE C. LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1385 HWY 35 # 284, MIDDLETOWN, NJ 07748-2012
(857) 829-4040
Mailing address
5401 FOREST EAST LN, STONE MOUNTAIN, GA 30088-2927
(678) 662-1609
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
GA
Other
Enumeration date
03/06/2024
Last updated
03/06/2024
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