Individual
LAURA LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1621 N BELT LINE RD STE A, MESQUITE, TX 75149-1795
(214) 909-8903
Mailing address
5407 BRYAN ST APT A202, DALLAS, TX 75206-8138
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
02/19/2021
Last updated
07/21/2021
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