GREGORY LONG

GRAPEVINE, TX
NPI1912322868
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: TX  11080)
Enumeration Date2014-03-02
Last Update Date2014-03-02
Business Address
-- GREGORY LONG LCDC
1400 W NORTHWEST HWY 260
GRAPEVINE, TX 76051-8113
Phone number: 817-319-9962
Mailing Address
-- GREGORY LONG LCDC
1400 W NORTHWEST HWY 260
GRAPEVINE, TX 76051-8113
Phone number: 817-319-9962
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