Individual
MR. MARK DELONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADAC II, MSED., CCS
Contact information
Practice address
645 N WALNUT ST, BLOOMINGTON, IN 47404-3846
(812) 336-3570
(812) 336-9010
Mailing address
653 W GREEN RD, BLOOMINGTON, IN 47403-4326
(812) 699-0144
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
C1192
IN
Other
Enumeration date
04/03/2007
Last updated
07/08/2007
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