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1962023879
BRIAN TIMOTHY LONG
ELIZABETHTOWN, KY
NPI
1962023879
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: KY 262683)
Enumeration Date
2020-05-01
Last Update Date
2020-05-04
Business Address
Dr. BRIAN TIMOTHY LONG PhD
413 E DIXIE AVE STE 106
ELIZABETHTOWN, KY 42701-1162
Phone number: 270-319-9899
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Mailing Address
Dr. BRIAN TIMOTHY LONG PhD
168 E VINE ST
RADCLIFF, KY 40160-2684
Phone number: 704-880-6124
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