Individual
DR. MARVIN LIONEL LONG JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED. D.
Contact information
Practice address
1626 VETERANS BLVD, SUITE E, DUBLIN, GA 31021-3576
(478) 272-1066
(478) 272-1066
Mailing address
1626 VETERANS BLVD, SUITE E, DUBLIN, GA 31021-3576
(478) 272-1066
(478) 272-1066
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
538
GA
Other
Enumeration date
12/12/2006
Last updated
07/08/2007
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