SHANEL ROSE LONG

PROVO, UT
NPI1184926214
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: UT  6500376-6006)
Enumeration Date2010-11-22
Last Update Date2010-11-22
Business Address
Mrs. SHANEL ROSE LONG L.S.A.C.
151 S UNIVERSITY AVE
PROVO, UT 84601-4427
Phone number: 801-851-7127
Mailing Address
Mrs. SHANEL ROSE LONG L.S.A.C.
794 N LOAFER CANYON RD
ELK RIDGE, UT 84651-8572
Phone number: 801-885-7372
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