Individual
ABAGAYL ALWAIZ NICALE LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
31950 23 MILE RD, CHESTERFIELD, MI 48047-4655
(480) 228-9991
Mailing address
51145 NICOLETTE DR, CHESTERFIELD, MI 48047-4585
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/30/2019
Last updated
09/30/2019
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