Organization
CHARLES A. LONG, A PROFESSIONAL MARRIAGE AND FAMILY THERAPY CORPORATIO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES ANTHONY LOPNG PSY D (MARRIAGE AND FAMILY THERAPIST)
(619) 462-0199
Entity
Organization
Contact information
Practice address
5480 BALTIMORE DR, SUITE 202, LA MESA, CA 91942-2020
(619) 462-0199
Mailing address
5480 BALTIMORE DR, SUITE 202, LA MESA, CA 91942-2020
(619) 462-0199
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MFC33504
CA
Other
Enumeration date
07/19/2013
Last updated
07/19/2013
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