Organization
BUSINESS CONSULTATION AND MANAGEMENT SERVICES
Active
Organization
BUSINESS CONSULTATION AND MANAGEMENT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARISSA LONG M.A.O.B., PSY.D. (PSYCHOLOGIST/ CONSULTANT)
(909) 263-5799
Entity
Organization
Contact information
Practice address
250 W 1ST ST, CLAREMONT, CA 91711-4736
(909) 263-5799
Mailing address
PO BOX 492, CLAREMONT, CA 91711-0492
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
PSY24675
CA
Other
Enumeration date
06/18/2013
Last updated
06/18/2013
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