Individual
CHANNING LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
610 W 28TH ST UNIT B, HOUSTON, TX 77008-1916
(806) 676-0190
Mailing address
610 W 28TH ST UNIT B, HOUSTON, TX 77008-1916
(806) 676-0190
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
118184
TX
Other
Enumeration date
06/23/2021
Last updated
06/23/2021
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