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Individual
REAGAN GRACE LONG
Active
Individual
REAGAN GRACE LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHC-A
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A23419
NC
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/24/2023
Last updated
08/31/2026
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