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1851151997
JUSTIN DAVID LONG
SALEM, OR
NPI
1851151997
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2024-03-19
Last Update Date
2024-03-19
Business Address
Mr. JUSTIN DAVID LONG
1160 LIBERTY ST SE
SALEM, OR 97302-4143
Phone number: 503-979-8151
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Mailing Address
Mr. JUSTIN DAVID LONG
1525 PARKSIDE CT NE
KEIZER, OR 97303-7704
Phone number:
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