Individual
DR. MARK A D LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ED.D.
Contact information
Practice address
249 W YORK ST, NORFOLK, VA 23510-1520
(757) 622-6794
(757) 626-1509
Mailing address
249 W YORK ST, NORFOLK, VA 23510-1520
(757) 622-6794
(757) 626-1509
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810001510
VA
Other
Enumeration date
02/28/2006
Last updated
07/08/2007
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