| NPI | 1245505205 |
|---|---|
| Former Name | CHAVONNE LONG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NM C-09259) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 1041C0700X Social Worker, Clinical (Licence: PA CW017810) | |
| Enumeration Date | 2012-03-09 |
| Last Update Date | 2024-11-22 |