Individual
MELISSA LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP CCC
Contact information
Practice address
1525 SPICED WINE AVE UNIT 7101, HENDERSON, NV 89074-2999
(801) 633-5569
Mailing address
1525 SPICED WINE AVE UNIT 7101, HENDERSON, NV 89074-2999
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
14045800
UT
Other
Enumeration date
08/09/2016
Last updated
08/09/2016
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