Individual
MS. AILSA MONIQUE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
205 PASADENA AVE, SOUTH PASADENA, CA 91030-2919
(323) 383-6909
Mailing address
205 PASADENA AVE, SOUTH PASADENA, CA 91030-2919
(949) 295-0353
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
40771
CA
Other
Enumeration date
03/09/2007
Last updated
06/04/2009
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