Individual
EBONY REESE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1092 E 145TH ST, CLEVELAND, OH 44110-3665
(216) 704-6176
Mailing address
1092 E 145TH ST, CLEVELAND, OH 44110-3665
(216) 704-6176
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
10/11/2022
Last updated
10/11/2022
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