Most Relevant Information
Provider Data
| NPI Number: | 1003432220 |
| Provider Name: | CAROLINE JANE LONG |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/23/2020 |
| Last Updated: | 06/23/2020 |
Provider Practice Location
2049 SKYLINE DR
LEMON GROVE
CA
919454221
Practice Location Phone/Fax
| Phone: | 6194657303 |
| Fax: |
Provider Mailing Location
1400 N JOHNSON AVE STE 101
EL CAJON
CA
920201651
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |