# JESSICA JEAN LONG

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1437760923
- **Gender:** F
- **Credential:** RD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133V00000X | Registered Dietitian | 86147917 | NH | — |
| 133VN1004X | Pediatric Nutrition Registered Dietitian | 5190 | MA | Yes |

## Other

- **Enumeration date:** 08/10/2020
- **Last updated:** 03/29/2021