Individual
MS. ANGELA DALE LONG
Active
Individual
MS. ANGELA DALE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
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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