Individual
RICHARD ANTHONY LONG JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
Mailing address
3202 MISTY CREEK DR, DECATUR, GA 30033-4442
(434) 509-8931
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC011639
GA
Other
Enumeration date
07/13/2020
Last updated
07/13/2020
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