Individual
DR. BRIAN TIMOTHY LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
413 E DIXIE AVE STE 106, ELIZABETHTOWN, KY 42701-1162
(270) 319-9899
Mailing address
168 E VINE ST, RADCLIFF, KY 40160-2684
(704) 880-6124
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
262683
KY
Other
Enumeration date
05/01/2020
Last updated
05/04/2020
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