DYLAN JAMES LONG

SAN PEDRO, CA
NPI1992518138
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  25036)
Enumeration Date2025-01-30
Last Update Date2025-01-30
Business Address
DYLAN JAMES LONG RAD-T
1003 S BEACON ST
SAN PEDRO, CA 90731-4324
Phone number: 424-505-9053
Mailing Address
DYLAN JAMES LONG RAD-T
1003 S BEACON ST
SAN PEDRO, CA 90731-4324
Phone number: 424-505-9053
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