Individual
MANDI LONGORIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RNC-OB, IBCLC
Contact information
Practice address
1201 MALLARD RUN, MIDLOTHIAN, TX 76065-5053
(817) 538-8877
Mailing address
1201 MALLARD RUN, MIDLOTHIAN, TX 76065-5053
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
L-88319
TX
Other
Enumeration date
09/07/2016
Last updated
09/07/2016
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