JONATHAN BRAXTON LONG

CONCORD, NC
NPI1053047753
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: NC  P016657)
Enumeration Date2022-07-26
Last Update Date2022-07-26
Business Address
JONATHAN BRAXTON LONG LCSW-A
280 EXECUTIVE PARK DR STE 100
CONCORD, NC 28025-1838
Phone number: 980-237-4766
Mailing Address
JONATHAN BRAXTON LONG LCSW-A
4429 IYAR WAY
WAKE FOREST, NC 27587-4167
Phone number: 252-532-1320