Individual
EBONIE S GOULBOURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
999 ASYLUM AVE, 2ND FLOOR, HARTFORD, CT 06105-2416
(860) 548-0030
Mailing address
999 ASYLUM AVE, 2ND FLOOR, HARTFORD, CT 06105-2416
(860) 548-0030
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
06/03/2008
Last updated
06/03/2008
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