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1720561806
PENNY KATHLEEN LONG
CHEHALIS, WA
NPI
1720561806
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA 60804582)
Enumeration Date
2018-09-13
Last Update Date
2018-09-13
Business Address
PENNY KATHLEEN LONG CDPT
121 NW CHEHALIS AVE
CHEHALIS, WA 98532-2010
Phone number: 360-740-9767
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Mailing Address
PENNY KATHLEEN LONG CDPT
121 NW CHEHALIS AVE
CHEHALIS, WA 98532-2010
Phone number: 360-740-9767
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