Individual
KEAUNDRA LATRECEA LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13501 HOOPER RD TRLR 176, HOUSTON, TX 77047-5078
(281) 747-9530
Mailing address
13501 HOOPER RD TRLR 176, HOUSTON, TX 77047-5078
(281) 747-9530
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
NA0008271107
TX
Other
Enumeration date
11/09/2017
Last updated
11/09/2017
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