Individual
DOVE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2109 FAIRBURN RD # A, DOUGLASVILLE, GA 30135-1037
(770) 726-7958
Mailing address
9359 OPAL DR, DOUGLASVILLE, GA 30135-2049
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/12/2018
Last updated
09/12/2018
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