Individual
MS. NICOLE LONGORIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DTR, NPTI, NSCA-CPT
Contact information
Practice address
1310 WALLACE ST, EDISON, NJ 08817-3384
(732) 754-8308
(732) 662-9392
Mailing address
1310 WALLACE ST, EDISON, NJ 08817-3384
(732) 754-8308
(732) 662-9392
Taxonomy
Speciality
Code
Description
License number
State
136A00000X
Registered Dietetic Technician
Primary
—
—
Other
Enumeration date
06/14/2011
Last updated
06/14/2011
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