-- THEODORE LONG ⚕️ California 1992045454

NPI	1992045454
Entity Type	Individual
Gender	Male
Sole Proprietor ?	Yes
Primary Taxonomy	1041C0700X Social Worker, Clinical (Licence: CA LCS 25432)
Enumeration Date	2013-02-20
Last Update Date	2013-02-20

-- THEODORE LONG

2100 PEABODY RD

VACAVILLE, CA 95687-6639

Phone number: 707-451-0182

-- THEODORE LONG

PO BOX 4000

VACAVILLE, CA 95696-4000

Phone number: 707-451-0182