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Individual

MS. DAPHNE I LONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CDCA

Contact information

Practice address
1699 MCCORMICK RD, GALLIPOLIS, OH 45631-8687
(740) 208-0811
Mailing address
1699 MCCORMICK RD, GALLIPOLIS, OH 45631-8687
(740) 208-0811

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
167991
OH

Other

Enumeration date
09/07/2018
Last updated
09/07/2018
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