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RAYMOND B. LONG BA

Pastoral >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1336701127

Individual Registrant:
 RAYMOND B. LONG BA
Gender: M
Not Sole Proprietor

Location and contact information for practice:
NORTHEAST OF BASHAS'  DILKON, AZ 86047 US
Tel: 928-657-8000  Fax: --

Contact information for business:
PO BOX 7072  WINSLOW, AZ 86047-7072 US
Tel: 928-657-8000  Fax: --

Registration Information:
NPI: 1336701127
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YP1600XBehavioral Health & Social Service Providers
Counselor
Pastoral

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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