Individual
DR. BILL RAY LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
531 N MAIN ST, PUNXSUTAWNEY, PA 15767-2580
(814) 938-3977
(813) 948-7339
Mailing address
531 N MAIN ST, PUNXSUTAWNEY, PA 15767-2580
(814) 938-3977
(813) 948-7339
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS-007666-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01479310
—
PA
Enumeration date
01/18/2007
Last updated
07/08/2007
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