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1114652773
MIRIAM D LONG
MARIETTA, GA
NPI
1114652773
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: GA LPC015269)
Enumeration Date
2022-07-19
Last Update Date
2024-11-11
Business Address
MIRIAM D LONG
738 WOODLAWN DR NE
MARIETTA, GA 30068-4253
Phone number: 770-726-9589
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Mailing Address
MIRIAM D LONG
12040 BROOKFIELD CLUB DR
ROSWELL, GA 30075-1259
Phone number: 310-927-8149
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