| Doctor Name: | DR. DELVIDA L. LONG |
| NPI Number: | 1871543736 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | PY 8241 |
| Business Practice Address: | 3278 Mitchell Blvd 23d Medical Group Moody Afb, GA - 316991500 |
| Business Phone Number: | 2292573898 |
| Business Fax Number: | |
| Mailing Address: | 3278 Mitchell Blvd, 23d Medical Group MOODY AFB |
| State: | GA |
| Postal Code: | 316991500 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 05/11/2006 |
| NPI Last Update Date: | 09/10/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PY 8241 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |