Individual
TACITA LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3018 OLD MINDEN RD, BOSSIER CITY, LA 71112-2476
(318) 658-9927
Mailing address
3018 OLD MINDEN RD, BOSSIER CITY, LA 71112-2476
(318) 658-9927
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/01/2015
Last updated
12/01/2015
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