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General NPI Number Information
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NPI Number | 1811970411
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Entity Type | Individual
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Provider Name | VALYNNE LONG MS, CGC
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Gender | Female
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Dates
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Enumeration Date | 11/29/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 979 E 3RD ST SUITE C 825
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City | CHATTANOOGA
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State | TN
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Zip | 37403-2136
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Country | US
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Telephone | 423-664-4460
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Fax | 423-664-4466
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Provider Business Mailing Address
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Address Line | 3837 NOWLIN RD NW
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City | KENNESAW
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State | GA
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Zip | 30144-5045
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Country | US
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Telephone | 770-241-2347
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 170300000X
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Taxonomy Name | Genetic Counselor (M.S.)
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License Number |
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License Number State |
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