Individual
LYRIC ALISHA LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
748 14TH AVE, LONGVIEW, WA 98632-2315
(360) 200-5419
Mailing address
748 14TH AVE, LONGVIEW, WA 98632-2315
(360) 200-5419
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
NC60854968
WA
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/23/2019
Last updated
02/07/2020
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