Individual
HALEY LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
950 W WOOSTER ST, BOWLING GREEN, OH 43402-2699
(419) 373-7656
Mailing address
23132 WINTERGREEN RD, GRAND RAPIDS, OH 43522-9757
(419) 575-9857
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-109438
OH
Other
Enumeration date
10/13/2022
Last updated
10/13/2022
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