Individual
BRUCE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
400 FORT HILL AVE, CANANDAIGUA, NY 14424-1159
(585) 393-7560
(585) 393-7568
Mailing address
245 AUDINO LN APT A, ROCHESTER, NY 14624-5622
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
075029
NY
Other
Enumeration date
05/07/2008
Last updated
05/07/2008
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