person
Penny Kathleen Long, CDPT
Addiction (Substance Use Disorder) Counselor in Chehalis, Washington
NPI 1720561806

Penny Kathleen Long is an Addiction (Substance Use Disorder) Counselor based in Chehalis, WA and is specialized in Addiction (Substance Use Disorder). Penny Kathleen Long practices in Chehalis, WA and has the professional credentials of CDPT. The NPI Number for Penny Kathleen Long is 1720561806 and holds a License No. 60804582 (Washington).

The current practice location address for Penny Kathleen Long is 121 Nw Chehalis Ave, Chehalis, WA and can be reached out via phone at 360-740-9767.

Location: 121 Nw Chehalis Ave, Chehalis, WA, 98532-2010
person
Provider Profile Details
NPI Number
1720561806
Provider Name
Penny Kathleen Long
Credential
CDPT
Provider Entity Type
Individual
Gender
Female
Address
121 Nw Chehalis Ave, Chehalis, WA, 98532-2010
Phone Number
360-740-9767
Fax Number
Provider Enumeration Date
09/13/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
60804582 01 WA DEPT OF HEALTH
institution
Provider Business Practice Location Address Details
Address
121 Nw Chehalis Ave
City
State
Zip
98532-2010
Phone Number
360-740-9767
Fax Number
person
Provider Business Mailing Address Details
Address
121 Nw Chehalis Ave
City
State
Zip
98532-2010
Phone Number
360-740-9767
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
60804582 (Washington)
Definition
Definition to come...
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