Doctor Name: | ERIN LONG |
NPI Number: | 1003142142 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | C 0700023 |
Business Practice Address: | 70 N Miller Rd Fairlawn, OH - 443333702 |
Business Phone Number: | 3308670066 |
Business Fax Number: | 3398670056 |
Mailing Address: | 70 N Miller Rd, FAIRLAWN |
State: | OH |
Postal Code: | 443333702 |
Phone Number: | 3308670066 |
Fax Number: | 3398670056 |
NPI Enumeration Date: | 10/25/2009 |
NPI Last Update Date: | 10/25/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | C 0700023 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |