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Individual
MR. BRIAN LEE LONG
Active
Individual
MR. BRIAN LEE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
006744
GA
Other
Enumeration date
03/27/2012
Last updated
02/28/2015
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