Individual
EBONY L FADIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
943 ROBERSON ST, COLUMBUS, OH 43201-3645
(614) 843-4210
Mailing address
1747 OLENTANGY RIVER RD # 1030, COLUMBUS, OH 43212-1453
(614) 843-4210
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/03/2021
Last updated
04/23/2024
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