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1013949809
MARK JACOB LONGSJO
BROCKTON, MA
NPI
1013949809
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: MA 1026908)
Enumeration Date
2006-07-06
Last Update Date
2007-07-08
Business Address
-- MARK JACOB LONGSJO LICSW
MCLEAN HOSPITAL SOUTHEAST LOCATION 940 BELMONT STREET
BROCKTON, MA 02301
Phone number: 508-894-8320
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Mailing Address
-- MARK JACOB LONGSJO LICSW
115 MILL ST
BELMONT, MA 02478-1041
Phone number: 508-894-8320
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