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Individual
DR. EDGAR CHARLES JOHN LONG
Active
Individual
DR. EDGAR CHARLES JOHN LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103TF0000X
Family Psychologist
Primary
4101005371
MI
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
11/23/2018
Last updated
11/23/2018
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