Individual
EBONY NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAT, BC-DMT
Contact information
Practice address
2000 FULTON ST, BROOKLYN, NY 11233-7074
(718) 795-7903
Mailing address
2000 FULTON ST, BROOKLYN, NY 11233-7074
Taxonomy
Speciality
Code
Description
License number
State
225600000X
Dance Therapist
Primary
002714-01
NY
Other
Enumeration date
11/23/2022
Last updated
12/31/2022
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