Individual provider · Type 1 NPI

Miles Owen Longino

Mental Health Counselor · Lawrenceville, GA

NPI number 1932094299 Active

Practice location

175 Gwinnett Dr
Lawrenceville, GA 30046-8444

Mailing address

627 Greenleaf Rd
Conyers, GA 30013-2276

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1932094299

Miles Owen Longino's National Provider Identifier is 1932094299, issued on Jun 9, 2025. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Lawrenceville, GA. The record was last updated on Jun 9, 2025.