Provider Demographics
NPI:1306437595
Name:RONALD L. DELONG, PH.D. & ASSOCIATES, LLC
Entity type:Organization
Organization Name:RONALD L. DELONG, PH.D. & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:L
Authorized Official - Last Name:DELONG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:937-459-4025
Mailing Address - Street 1:607 S BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45331-1929
Mailing Address - Country:US
Mailing Address - Phone:937-459-4025
Mailing Address - Fax:
Practice Address - Street 1:607 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:OH
Practice Address - Zip Code:45331-1929
Practice Address - Country:US
Practice Address - Phone:937-459-4025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-29
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)