Individual
BRIAN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
751A CAMINO PLZ, SAN BRUNO, CA 94066-3401
(650) 627-8045
Mailing address
2 KINGSTON ST, SAN FRANCISCO, CA 94110-5414
(484) 888-3677
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-15-17942
PA
Other
Enumeration date
07/26/2016
Last updated
07/26/2016
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