Individual
EBONY EVERETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1220 2ND AVE, COLUMBUS, GA 31901-5241
(706) 571-9128
(706) 571-9242
Mailing address
1220 2ND AVE, COLUMBUS, GA 31901-5241
(706) 571-9128
(706) 571-9242
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/20/2015
Last updated
04/20/2015
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