Individual
TRACI RENEE' LONGLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OWNER/ADMINISTRATOR
Contact information
Practice address
15595 LONGSPUR LN., TERRELL, TX 75160
(972) 563-9045
(972) 563-9045
Mailing address
15595 LONGSPUR LN., TERRELL, TX 75160
(972) 563-9045
(972) 563-9045
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
04/12/2012
Last updated
09/13/2012
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