Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | C 0700023 | OH |
N | 101YP2500X | Professional Counselor | C.0700023 | OH |
NPI | 1003142142 |
---|---|
Provider Name | Erin Marie Long |
First Address | Hudson, OH 44236-2631 |
Second Address | San Francisco, CA 94105-0920 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2009 |
Last Update Date | 18/02/2021 |