Individual
DIANE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., LPC
Contact information
Practice address
8207 HUDSON AVE, LUBBOCK, TX 79423-2805
(806) 780-0003
(806) 780-0007
Mailing address
8207 HUDSON AVE, LUBBOCK, TX 79423-2805
(806) 780-0003
(806) 780-0007
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
17725
TX
Other
Enumeration date
12/14/2006
Last updated
07/08/2007
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