Individual
DIANE MARIE LONGERBONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA.,RD.,CD.
Contact information
Practice address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 988-2853
Mailing address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 988-2853
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
37000514A
IN
Other
Enumeration date
08/04/2008
Last updated
08/04/2008
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