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Individual
GREGORY A LONG
Active
Individual
GREGORY A LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
172
WY
Other
Enumeration date
12/09/2005
Last updated
03/25/2011
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