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Individual

DR. LARRY EUGENE LONG JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
2904 WEST 72 STREET, PRAIRIE VILLAGE, KS 66208
(913) 442-7613
(913) 442-7613
Mailing address
2904 WEST 72 STREET, PRAIRIE VILLAGE, KS 66208
(913) 442-7613
(913) 442-7613

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
1166
KS
103TC1900X
Counseling Psychologist
Primary
1397
KS
103TC1900X
Counseling Psychologist
2002002936
MO

Other

Enumeration date
11/17/2006
Last updated
11/18/2025
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