Individual
EBONY THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1850 CHADWICK DR, JACKSON, MS 39204-3404
(601) 421-9720
Mailing address
PO BOX 7232, JACKSON, MS 39282-7232
(601) 421-9720
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C7831
MS
Other
Enumeration date
11/16/2017
Last updated
11/16/2017
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