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Individual

DR. JOHN WESLEY LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
1530 UNION RD STE A, GASTONIA, NC 28054-2201
(704) 861-0271
(704) 861-0374
Mailing address
118 AIRPORT RD, STANLEY, NC 28164-1202
(704) 263-0425
(704) 861-0374

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0463
NC

Other

Enumeration date
01/19/2006
Last updated
02/14/2008
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