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Individual
MARY CATHERINE LONG
Active
Individual
MARY CATHERINE LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
11003RE
GA
Other
Enumeration date
04/29/2013
Last updated
04/29/2013
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