JUSTIN DAVID LONG

SALEM, OR
NPI1851151997
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2024-03-19
Last Update Date2024-03-19
Business Address
Mr. JUSTIN DAVID LONG
1160 LIBERTY ST SE
SALEM, OR 97302-4143
Phone number: 503-979-8151
Mailing Address
Mr. JUSTIN DAVID LONG
1525 PARKSIDE CT NE
KEIZER, OR 97303-7704
Phone number: