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Individual

LAURIE LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3500 W MAPLE RD, STE. C, BLOOMFIELD HILLS, MI 48301-3308
(248) 203-9760
(248) 203-6690
Mailing address
3500 W MAPLE RD, STE. C, BLOOMFIELD HILLS, MI 48301-3308
(248) 203-9760
(248) 203-6690

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
1601000160
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1601000160
LICENSE
MI
Enumeration date
03/12/2008
Last updated
01/10/2012
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