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Individual
MRS. VIRGINIA BREWER LONG
Active
Individual
MRS. VIRGINIA BREWER LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3106
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3403400
—
NC
01
—
52850
BCBS
NC
Enumeration date
06/18/2008
Last updated
10/27/2009
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