Individual
MARIAH LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2520 ELISHA AVE, ZION, IL 60099-2676
(847) 872-4072
Mailing address
2520 ELISHA AVE, ZION, IL 60099-2676
Taxonomy
Speciality
Code
Description
License number
State
133VN1301X
Oncology Nutrition Registered Dietitian
Primary
164.007783
IA
Other
Enumeration date
02/28/2020
Last updated
02/28/2020
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