Individual
RICHARD P LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MFT
Contact information
Practice address
1350 15TH AVE, COLUMBUS, GA 31901-2308
(706) 327-3238
Mailing address
609 BROADWAY, COLUMBUS, GA 31901-2918
(706) 596-8952
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT000855
GA
Other
Enumeration date
05/23/2007
Last updated
07/08/2007
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