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Individual

MICHELE E LONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
8395 OSWEGO RD, BALDWINSVILLE, NY 13027-6801
(315) 450-4898
Mailing address
1803 STATE ROUTE 3, STERLING, NY 13156-3126
(315) 391-0110

Taxonomy

Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1384290201
STUDENTS WITH DISABILITIES BIRTH-2 TEACHING CERTIFICATE
NY
01
1384444201
STUDENTS WITH DISABILITIES 1-6 TEACHING CERTIFICATE
NY
Enumeration date
06/14/2021
Last updated
06/14/2021
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