Individual
MR. BRIAN LEE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
410 PEACHTREE PKWY, 4245, CUMMING, GA 30041-7066
(404) 644-8967
Mailing address
562 LAKELAND PLZ # 326, CUMMING, GA 30040-2783
(404) 644-8967
(678) 261-1622
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
006744
GA
Other
Enumeration date
03/27/2012
Last updated
02/28/2015
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