Individual
EBONI TAKENDRIA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3993 SHINAULT LN, MEMPHIS, TN 38125-2649
(901) 857-9107
Mailing address
3993 SHINAULT LANE, MEMPHIS, TN 38125
(901) 857-9107
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
47 4445545
TN
Other
Enumeration date
07/14/2015
Last updated
07/14/2015
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