Individual
DR. STEPHANIE ROBERTS LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD DOCTOR AUDILOGY
Contact information
Practice address
W3124 VAN ROY RD, APPLETON, WI 54915-3982
(920) 915-9077
Mailing address
W3124 VAN ROY RD, APPLETON, WI 54915-3982
(920) 915-9077
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
232-156
WI
231HA2400X
Assistive Technology Practitioner Audiologist
232-156
WI
237600000X
Audiologist-Hearing Aid Fitter
232-156
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41128700
—
WI
Enumeration date
04/25/2008
Last updated
05/11/2010
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