Individual
EBONI JOI FIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2435 W KOWALSKY LN, PHOENIX, AZ 85041-4471
(602) 741-1660
Mailing address
2435 W KOWALSKY LN, PHOENIX, AZ 85041-4471
(602) 741-1660
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
Primary
LPC-18562
AZ
Other
Enumeration date
10/24/2019
Last updated
06/05/2024
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