Individual
DR. LISA LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1524 DUCKWORTH AVE, CHARLOTTE, NC 28208-4315
(980) 267-5153
Mailing address
1524 DUCKWORTH AVE, CHARLOTTE, NC 28208-4315
(980) 267-5153
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
06/13/2011
Last updated
06/28/2016
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