Individual
ELISA MARIE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
45 N CANFIELD NILES RD, YOUNGSTOWN, OH 44515-2343
(330) 330-8777
Mailing address
45 N CANFIELD NILES RD, YOUNGSTOWN, OH 44515-2343
(330) 330-8777
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
172701
OH
Other
Enumeration date
01/06/2020
Last updated
02/05/2020
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