Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MARIAH LONG
ActiveOncology Nutrition · ZION, IL
Registration Details
- NPI Number
- 1306470364
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Feb 28, 2020 (6.1460054491885 yrs)
- Last Updated
- Feb 28, 2020
- License
-
164.007783 (IA)
Practice Information
- Address
-
2520 ELISHA AVEZION, IL, 600992676Browse IL providers · Browse ZIP 60099
- Phone
- 8478724072
- Primary Specialty
-
Oncology Nutrition
133VN1301X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.