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Individual
DEBRA LONG
Active
Individual
DEBRA LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
1738
MS
101YA0400X
Addiction (Substance Use Disorder) Counselor
0101
MS
Other
Enumeration date
08/14/2014
Last updated
08/14/2014
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