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Individual
ALICA LONG
Active
Individual
ALICA LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A. CCC-A
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
A-973
WY
237600000X
Audiologist-Hearing Aid Fitter
A-973
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
235
—
NE
05
—
507621740
—
NE
01
—
P00297942
PALMENTO GBA RR MEDICARE
NE
01
—
W308228
SOUTH DAKOTA MEDICARE
NE
Enumeration date
07/27/2006
Last updated
11/19/2025
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