Long, Alica

Long, Alica is an individual health care provider with primary practice located at 300 Green Ave. , Gillette WY 82716-4045. She recently has 2 registered licenses in different health care specialties including Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter, Speech, Language and Hearing Service Providers / Audiologist. Speech, Language and Hearing Service Providers / Audiologist is her primary health care specialty. Long, Alica can be contacted via phone (307) 689-3611.

Contact Information

Primary practice address
300 Green Ave. Gillette WY 82716-4045
Phone: (307) 689-3611
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter 237600000X A-973 Wyoming
Speech, Language and Hearing Service Providers / Audiologist 231H00000X A-973 Wyoming

Profile Details

NPI number 1659385813
LBN Legal business name Long, Alica
Credentials M.A. CCC-A
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 27th, 2006
Last updated Sep 14th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659385813 NPPES
Nebraska MEDICAID 507621740
Nebraska MEDICAID 235
Nebraska Other P00297942
Nebraska Other W308228

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