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Individual

MS. EBONY B. PAYNS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
24755 5 MILE RD STE 207, REDFORD, MI 48239-3664
(248) 837-5877
Mailing address
10327 MICHAEL ST, TAYLOR, MI 48180-3210
(248) 837-5877

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801092438
MI
1041C0700X
Clinical Social Worker
6801092438
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8845650
MI
Enumeration date
06/14/2011
Last updated
04/28/2021
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