Individual
EBONI COFFEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
9410 KILIMANJARO RD, COLUMBIA, MD 21045-3955
(410) 313-6945
(410) 313-6948
Mailing address
1114 PINE HEIGHTS AVE, BALTIMORE, MD 21229-5210
(410) 952-5512
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
A0000195
MD
Other
Enumeration date
09/05/2014
Last updated
09/05/2014
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