Individual
EVAN MARK LONGIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.D.
Contact information
Practice address
204 LAFAYETTE ST, SALEM, MA 01970-4721
(978) 744-5006
(978) 744-9799
Mailing address
204 LAFAYETTE ST, SALEM, MA 01970-4721
(978) 744-5006
(978) 744-9799
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1693
MA
Other
Enumeration date
10/26/2006
Last updated
05/13/2014
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