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Organization
DEDE LONG MED, LPC, PC
Active
Organization
DEDE LONG MED, LPC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEDE STUNTZ LONG MED, LPC (PRESIDENT)
(806) 535-1952
Entity
Organization
Contact information
Practice address
2545 74TH ST, LUBBOCK, TX 79423-1405
(806) 535-1952
Mailing address
PO BOX 427, SHALLOWATER, TX 79363-0427
(806) 535-1952
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
17725
TX
Other
Enumeration date
11/03/2016
Last updated
11/03/2016
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