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1073861779
KELLIE NICOLE LONG
SAN DIEGO, CA
NPI
1073861779
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2012-08-28
Last Update Date
2012-08-28
Business Address
-- KELLIE NICOLE LONG BSW
3255 WING ST
SAN DIEGO, CA 92110-4638
Phone number: 619-221-8600
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Mailing Address
-- KELLIE NICOLE LONG BSW
3255 WING ST
SAN DIEGO, CA 92110-4638
Phone number: 619-221-8600
Copy
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