Individual
MARISA LOUISE EBRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6000 JEFFERSON AVE, NEWPORT NEWS, VA 23605-3266
(757) 933-2660
Mailing address
1341 24TH ST, NEWPORT NEWS, VA 23607-4807
(757) 553-2897
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
0903002945
VA
Other
Enumeration date
02/19/2020
Last updated
02/19/2020
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