Individual
TRUMAN GEORGE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC III
Contact information
Practice address
2100 CHURCH STREET, EAST TROY, WI 53120-0621
(262) 642-5080
(262) 642-5146
Mailing address
1421 RACINE ST # B, DELAVAN, WI 53115-1467
(262) 642-5080
(262) 642-5146
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1009
WI
Other
Enumeration date
01/16/2007
Last updated
07/08/2007
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