Individual
MS. SHELLEY MARIE LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
279 SUMMIT DR, WATERFORD, MI 48328-3364
(248) 745-4900
Mailing address
865 N LAPEER RD, LAKE ORION, MI 48362-1532
(618) 518-9072
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
04/26/2023
Last updated
04/26/2023
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