Individual
ANGELA LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3584 FAIRLANES AVE SW STE 2, GRANDVILLE, MI 49418-1583
(616) 222-5300
(616) 531-0447
Mailing address
3584 FAIRLANES AVE SW STE 2, GRANDVILLE, MI 49418-1583
(616) 222-5300
(616) 531-0447
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/22/2021
Last updated
07/22/2021
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