Individual
ELIZABETH LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
307 UPTON ST, WINSTON SALEM, NC 27103-1735
(336) 837-4222
(336) 419-2755
Mailing address
836 OAK ST, STE 200, WINSTON SALEM, NC 27101-1452
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
11517
NC
Other
Enumeration date
04/12/2017
Last updated
05/15/2019
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