Individual
LISE D DELONG
Active
Individual
LISE D DELONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D. CPCRT
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
01/17/2011
Last updated
01/17/2011
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