Individual
EBONY LOCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1708 KINGS ROW, SLIDELL, LA 70461-4428
(504) 270-6556
Mailing address
1708 KINGS ROW, SLIDELL, LA 70461-4428
(504) 270-6556
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
PLC10777
LA
Other
Enumeration date
09/02/2025
Last updated
09/02/2025
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