Individual
JEAN-MARIE EBONYI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
427 E ASH AVE, DECATUR, IL 62526-6117
(574) 387-4313
Mailing address
215 RED COACH DR, MISHAWAKA, IN 46545-8307
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-470092
IL
Other
Enumeration date
09/11/2025
Last updated
09/11/2025
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