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1760503718
MARK DELONG
BLOOMINGTON, IN
NPI
1760503718
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: IN C1192)
Enumeration Date
2007-04-03
Last Update Date
2007-07-08
Business Address
Mr. MARK DELONG CADAC II, MSEd., CCS
645 N WALNUT ST
BLOOMINGTON, IN 47404-3846
Phone number: 812-336-3570
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Mailing Address
Mr. MARK DELONG CADAC II, MSEd., CCS
653 W GREEN RD
BLOOMINGTON, IN 47403-4326
Phone number: 812-699-0144
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