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Individual
MRS. KATIE JO LONG
Active
Individual
MRS. KATIE JO LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RRT
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
10184683
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10184683
RESPIRATORY THERAPY LICENSE
OR
Enumeration date
07/02/2020
Last updated
07/02/2020
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