Individual
DR. GREGORY A LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1 LUCINDA AVE., NIU SPEECH-LANGUAGE AND HEARING CLINIC, DEKALB, IL 60115-2899
(815) 753-6508
Mailing address
1 LUCINDA AVE., NIU SPEECH-LANGUAGE AND HEARING CLINIC, DEKALB, IL 60115-2899
(815) 753-6508
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
86-13P
AR
Other
Enumeration date
12/04/2006
Last updated
07/08/2007
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