Individual
EBONY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4601 BAILEYS RIDGE DR APT 6, PRINCE GEORGE, VA 23875-1457
(804) 605-3963
Mailing address
4601 BAILEYS RIDGE DR APT 6, PRINCE GEORGE, VA 23875-1457
(804) 605-3963
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
04/30/2025
Last updated
04/30/2025
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