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1144820572
KAITLYN SHEA LONG
PORTLAND, OR
NPI
1144820572
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Additional Taxonomies
106S00000X Behavior Technician
Enumeration Date
2020-10-26
Last Update Date
2022-10-31
Business Address
KAITLYN SHEA LONG
3415 SE POWELL BLVD
PORTLAND, OR 97202-3371
Phone number: 888-295-6996
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Mailing Address
KAITLYN SHEA LONG
3415 SE POWELL BLVD
PORTLAND, OR 97202-3371
Phone number: 503-234-9591
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