Individual
MIAH LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1976 GARDEN AVE, EUGENE, OR 97403-1933
(541) 255-1411
(541) 255-1412
Mailing address
1976 GARDEN AVE, EUGENE, OR 97403-1933
(541) 255-1411
(541) 255-1412
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
C8299
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500709003
—
OR
Enumeration date
03/23/2016
Last updated
03/12/2025
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