Organization
DAWN LEA LONG COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DAWN LEA LONG MHR LADC LBHP (OWNER/OPERATOR/ COUNSELOR)
(405) 863-2602
Entity
Organization
Contact information
Practice address
5350 S WESTERN AVE STE 211, OKLAHOMA CITY, OK 73109-4525
(405) 863-2602
Mailing address
5350 S WESTERN AVE STE 211, OKLAHOMA CITY, OK 73109-4525
(405) 863-2602
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1213
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200386090B
—
OK
Enumeration date
07/11/2018
Last updated
07/11/2018
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