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1356129217
OCTAVIS LAQUAN LONG
EAST LANSING, MI
NPI
1356129217
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103T00000X Psychologist
(Licence: MI 6361002091)
Enumeration Date
2023-09-20
Last Update Date
2023-09-20
Business Address
OCTAVIS LAQUAN LONG
715 BUTEO DR
EAST LANSING, MI 48823-8304
Phone number: 517-614-5200
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Mailing Address
OCTAVIS LAQUAN LONG
715 BUTEO DR
EAST LANSING, MI 48823-8304
Phone number: 517-614-5200
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