Most Relevant Information
Provider Data
| NPI Number: | 1003674714 |
| Provider Name: | LAUREL LONG |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | ABA-IN-10241615 |
Most Important Dates
| Enumeration Date: | 03/07/2024 |
| Last Updated: | 03/12/2024 |
Provider Practice Location
27777 INKSTER RD STE 100
FARMINGTON HILLS
MI
483345312
Practice Location Phone/Fax
| Phone: | 8557728847 |
| Fax: |
Provider Mailing Location
27777 INKSTER RD
FARMINGTON HILLS
MI
483345310
Provider Mailing Phone/Fax
| Phone: | 2484364400 |
| Fax: |