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Individual

BRITTANY LONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S., CCC-SLP

Contact information

Practice address
1460 ELK CREEK DR, IDAHO FALLS, ID 83404-8237
(208) 535-1286
Mailing address
1462 S BELLIN RD, IDAHO FALLS, ID 83402-3873
(774) 217-9484

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-4093
ID

Other

Enumeration date
02/11/2022
Last updated
02/11/2022
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