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Individual

MS. ANGELA DALE LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
1 TRAFALGAR SQ STE 204, NASHUA, NH 03063-1998
(603) 577-5517
(603) 402-3551
Mailing address
1 TRAFALGAR SQ STE 204, NASHUA, NH 03063-1998
(603) 577-5517
(603) 402-3551

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
980
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14Y001084NH03
BLUE CROSS BLUE SHIELD
NH
05
30424141
NH
01
385828
MVP
NH
01
51-0566390
CIGNA
NH
01
51-0566390-01
PACIFICARE
NH
Enumeration date
01/16/2007
Last updated
07/24/2019
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