Organization
CLIO LONG, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLIO LONG PSY.D (OWNER)
(703) 479-5610
Entity
Organization
Contact information
Practice address
8101 HINSON FARM RD STE 117, ALEXANDRIA, VA 22306-3404
(703) 479-5610
Mailing address
8101 HINSON FARM RD STE 117, ALEXANDRIA, VA 22306-3404
(703) 479-5610
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
0810004025
VA
103TC0700X
Clinical Psychologist
Primary
0810004025
VA
103TH0004X
Health Psychologist
0810004025
VA
103TR0400X
Rehabilitation Psychologist
0810004025
VA
Other
Enumeration date
02/18/2016
Last updated
03/21/2016
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