Individual
KRYSTAL LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LCAS-A
Contact information
Practice address
245 SHORT HILLS DR, CHARLOTTE, NC 28217-8033
(704) 401-7522
Mailing address
245 SHORT HILLS DR, CHARLOTTE, NC 28217-8033
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-25613
NC
Other
Enumeration date
06/21/2021
Last updated
06/21/2021
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