JESSICA JEAN LONG

WORCESTER, MA
NPI1437760923
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy133VN1004X Dietitian, Registered, Nutrition, Pediatric
(Licence: MA  5190)
Additional Taxonomies133V00000X Dietitian, Registered
(Licence: NH  86147917)
Enumeration Date2020-08-10
Last Update Date2021-03-29
Business Address
JESSICA JEAN LONG RD
55 LAKE AVE N
WORCESTER, MA 01655-0002
Phone number: 774-441-7615
Mailing Address
JESSICA JEAN LONG RD
PO BOX 415348
BOSTON, MA 02241-5348
Phone number: 800-225-8885