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1336508415
HAZEL LONG
SACATON, AZ
NPI
1336508415
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: AZ 11544)
Enumeration Date
2016-02-17
Last Update Date
2016-02-17
Business Address
Mrs. HAZEL LONG LISAC
483 W. SEED FARM RD.
SACATON, AZ 85147-0001
Phone number: 602-528-1200
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Mailing Address
Mrs. HAZEL LONG LISAC
PO BOX 38
SACATON, AZ 85147-0001
Phone number: 602-528-1200
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