Individual
TATJANA A LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC, LSAA, ATR-P
Contact information
Practice address
1264 RODEO RD, SANTA FE, NM 87505-6816
(505) 982-2129
Mailing address
1264 RODEO RD, SANTA FE, NM 87505-6816
(505) 982-2129
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CSA0195171
NM
Other
Enumeration date
07/06/2018
Last updated
12/29/2020
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