THEODORE LONG

VACAVILLE, CA
NPI1992045454
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: CA  LCS 25432)
Enumeration Date2013-02-20
Last Update Date2013-02-20
Business Address
-- THEODORE LONG
2100 PEABODY RD
VACAVILLE, CA 95687-6639
Phone number: 707-451-0182
Mailing Address
-- THEODORE LONG
PO BOX 4000
VACAVILLE, CA 95696-4000
Phone number: 707-451-0182
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