Most Relevant Information
Provider Data
| NPI Number: | 1003372145 |
| Provider Name: | KELSEY ANNE LONGORIA |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/13/2019 |
| Last Updated: | 02/13/2019 |
Provider Practice Location
960 DIVINE WAY
NEW BRAUNFELS
TX
781303095
Practice Location Phone/Fax
| Phone: | 8398576494 |
| Fax: |
Provider Mailing Location
960 DIVINE WAY
NEW BRAUNFELS
TX
781303095
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |