Individual
ALEXIS R. LONGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
70 PARK ST STE 104, MONTCLAIR, NJ 07042-2960
(862) 234-5029
Mailing address
70 PARK ST STE 104, MONTCLAIR, NJ 07042-2960
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/06/2022
Last updated
10/06/2022
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