Individual
MEGAN LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
300 RACE ST, WISCONSIN DELLS, WI 53965-1822
(608) 254-2574
Mailing address
805 TANGLEWOOD DR APT 106, DEFOREST, WI 53532-1795
(715) 323-6697
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4330154
WI
Other
Enumeration date
07/21/2016
Last updated
07/21/2016
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