Individual
GERI ANNE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDP
Contact information
Practice address
4800 COLLEGE ST SE, LACEY, WA 98503-4389
(509) 990-8775
Mailing address
14148 TILLEY RD S, TENINO, WA 98589-9222
(509) 990-8775
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60027739
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
RC00054823
WA
Other
Enumeration date
07/31/2007
Last updated
03/24/2017
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