Individual
EBONY L DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
629 JEWETT AVE, BRIDGEPORT, CT 06606-2836
(850) 264-2100
Mailing address
2730 OLDFIELD DR, MONROE, NC 28110-5400
(203) 423-9541
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
Primary
3765
CT
Other
Enumeration date
11/03/2011
Last updated
07/11/2022
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