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1194182675
MATTHEW LONGFELLOW
CHARLESTOWN, IN
NPI
1194182675
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: IN 101YA0400X)
Enumeration Date
2016-01-28
Last Update Date
2016-01-28
Business Address
MATTHEW LONGFELLOW
7509 CHARLESTOWN PIKE
CHARLESTOWN, IN 47111-9623
Phone number: 812-256-4686
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Mailing Address
MATTHEW LONGFELLOW
7509 CHARLESTOWN PIKE
CHARLESTOWN, IN 47111-9623
Phone number: 812-256-4686
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