Individual
BRENDA CHANTHOU LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4700 SCHAEFER RD STE 340, DEARBORN, MI 48126-3743
(313) 561-5100
(313) 447-2438
Mailing address
4700 SCHAEFER RD STE 340, DEARBORN, MI 48126-3743
(313) 561-5100
(313) 447-2438
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
02/17/2023
Last updated
02/17/2023
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