Individual
ALLISA LONGBRAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
64301 LUTZ RD, CONSTANTINE, MI 49042-8718
(269) 221-3423
Mailing address
64301 LUTZ RD, CONSTANTINE, MI 49042-8718
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
05/28/2026
Last updated
05/28/2026
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