Individual
MISS STEPHANIE ANN LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD,CDE
Contact information
Practice address
509 N BROAD ST, WOODBURY, NJ 08096-1617
(856) 686-5167
Mailing address
1023 N MAIN ST, PITMAN, NJ 08071-2445
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
03/26/2013
Last updated
04/16/2014
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