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Individual

MR. ANTHONY WAYNE LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CDCA

Contact information

Practice address
4000 E MAIN ST, COLUMBUS, OH 43213-2950
(614) 334-6903
Mailing address
4214 E MAIN ST, WHITEHALL, OH 43213-3028
(614) 483-8055

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.178725
OH

Other

Enumeration date
10/25/2021
Last updated
10/25/2021
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