Individual
EBONI ANICKA GOLDSBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N/A
Contact information
Practice address
506 HIGHWAY 2, STERLINGTON, LA 71280
(318) 598-5040
(844) 270-1958
Mailing address
10649 EDGEWOOD DR, BASTROP, LA 71220-9685
(318) 789-1978
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497113559
—
LA
Enumeration date
09/27/2017
Last updated
05/17/2018
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