Individual
DR. EDGAR CHARLES JOHN LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2163 CORNERSTONE DR, MT PLEASANT, MI 48858-8029
(989) 330-2417
Mailing address
2163 CORNERSTONE DR, MOUNT PLEASANT, MI 48858-8029
(989) 330-2417
Taxonomy
Speciality
Code
Description
License number
State
103TF0000X
Family Psychologist
Primary
4101005371
MI
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
11/23/2018
Last updated
11/23/2018
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