Individual
LAURA LONGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
4 AVIS DR STE 101, LATHAM, NY 12110-2650
(518) 560-4277
(518) 662-4277
Mailing address
4 AVIS DR STE 101, LATHAM, NY 12110-2650
(518) 560-4277
(518) 662-4277
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
024109
NY
Other
Enumeration date
12/02/2022
Last updated
12/02/2022
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