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Individual

ANGELA LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LSW

Contact information

Practice address
18 CAMPUS BLVD STE 100, NEWTOWN SQUARE, PA 19073-3240
(267) 995-4065
Mailing address
12 ROLLING RD, EAST BRUNSWICK, NJ 08816-4125
(732) 616-6550

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
44SL06648200
NJ

Other

Enumeration date
04/07/2022
Last updated
04/07/2022
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