Individual
BRIAN LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
815 BROADWAY, HANOVER, PA 17331-2016
(717) 417-4578
Mailing address
815 BROADWAY, HANOVER, PA 17331-2016
(717) 417-4578
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PC016203
PA
Other
Enumeration date
10/23/2023
Last updated
10/23/2023
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