OCTAVIS LAQUAN LONG

EAST LANSING, MI
NPI1356129217
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy103T00000X Psychologist
(Licence: MI  6361002091)
Enumeration Date2023-09-20
Last Update Date2023-09-20
Business Address
OCTAVIS LAQUAN LONG
715 BUTEO DR
EAST LANSING, MI 48823-8304
Phone number: 517-614-5200
Mailing Address
OCTAVIS LAQUAN LONG
715 BUTEO DR
EAST LANSING, MI 48823-8304
Phone number: 517-614-5200
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