Traci Renee' Longley, OWNER/ADMINISTRATOR

NPI #1639436934 in Terrell, Texas

Provider Information

NPI Number
1639436934
Entity Type
Individual
Name
Traci Renee' Longley, OWNER/ADMINISTRATOR
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Community Health Worker
Credential
OWNER/ADMINISTRATOR
Enumeration Date
Apr 12, 2012
Last Updated
Sep 13, 2012

Practice Location

Address
15595 LONGSPUR LN.
State
Texas
ZIP Code
75160
Phone
(972) 563-9045

Specialties & Taxonomy Codes

Specialty
Community Health Worker

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