Brooke Lynne Long, RD
Dietitian, Registered in Somerset Center, MI. Individual provider (NPI-1).
NPI number1245066232
StatusActive
Last updated in NPPESOct 22, 2024
Details
- NPI
- 1245066232
- Entity type
- Individual (NPI-1)
- Name
- Brooke Lynne Long
- Credential
- RD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 9, 2024
- Certification date
- Oct 22, 2024
- Last updated
- Oct 22, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | 103961 | IN | Yes |
Practice location
Po Box 21Somerset Center, MI 49282-0021
Phone 225-361-6691
Mailing address
Po Box 21Somerset Center, MI 49282-0021
Phone 225-361-6691
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