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General NPI Number Information
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NPI Number | 1477251460
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Entity Type | Organization
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Legal Business Name | ALLISON LONG LLC
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Dates
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Enumeration Date | 02/20/2023
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 4600 MILITARY TRL STE 103
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City | JUPITER
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State | FL
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Zip | 33458-4811
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Country | US
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Telephone | 561-768-4248
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Fax | 561-249-7432
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Provider Business Mailing Address
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Address Line | 431 JUPITER LAKES BLVD APT 2121B
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City | JUPITER
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State | FL
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Zip | 33458-7124
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Country | US
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Telephone | 561-768-4248
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Fax | 561-249-7432
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALLISON LELANIA LONG
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Credential | DNP, PMHNP-BC
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Telephone | 561-629-0454
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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