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1447296629
JACK MARTIN LONG
CATONSVILLE, MD
NPI
1447296629
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: MD 03068)
Enumeration Date
2006-06-22
Last Update Date
2011-12-12
Business Address
Dr. JACK MARTIN LONG Ph.D.
720C MAIDEN CHOICE LN
CATONSVILLE, MD 21228-5940
Phone number: 410-744-5499
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Mailing Address
Dr. JACK MARTIN LONG Ph.D.
720 MAIDEN CHOICE LN SUITE C
CATONSVILLE, MD 21228-5940
Phone number: 410-744-5499
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