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1770052326
PAMELA C LONG
BELOIT, WI
NPI
1770052326
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2018-11-13
Last Update Date
2018-11-13
Business Address
PAMELA C LONG
2240 PRAIRIE AVE
BELOIT, WI 53511-2648
Phone number: 608-361-7200
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Mailing Address
PAMELA C LONG
975 S BELL SCHOOL RD
ROCKFORD, IL 61108-4457
Phone number: 779-770-4237
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