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1740801752
MITSI TONETTE LONG
SHREVEPORT, LA
NPI
1740801752
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: LA 210781)
Enumeration Date
2020-04-30
Last Update Date
2020-04-30
Business Address
MITSI TONETTE LONG PMHNP
3341 YOUREE DR STE 205
SHREVEPORT, LA 71105-2149
Phone number: 318-219-4167
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Mailing Address
MITSI TONETTE LONG PMHNP
143 INWOOD RD
TEXARKANA, TX 75501-8768
Phone number: 903-293-6679
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