Individual
MRS. SUSAN JOY LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
309 ELM AVE, TILLAMOOK, OR 97141-3437
(503) 812-6788
Mailing address
1011 MEADOW AVE, TILLAMOOK, OR 97141-2849
(503) 812-6788
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
T0918
OR
Other
Enumeration date
05/14/2007
Last updated
10/13/2015
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