Organization
YOUR LONG RUN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY K BUSH LPC (PRESIDENT/PROVIDER)
(540) 525-8113
Entity
Organization
Contact information
Practice address
2742 FLETCHER ST, SALEM, VA 24153-2124
(540) 525-8113
Mailing address
2742 FLETCHER ST, SALEM, VA 24153-2124
(540) 525-8113
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/21/2017
Last updated
07/21/2022
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