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Individual

DR. SHELLEY LYNN LONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
325 OXFORD CT, ROANOKE, TX 76262-5063
(979) 571-5046
Mailing address
325 OXFORD CT, ROANOKE, TX 76262-5063
(979) 571-5046

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
19815
TX
103TC1900X
Counseling Psychologist
Primary
36498
TX

Other

Enumeration date
11/02/2016
Last updated
11/02/2016
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