Individual
EBONY HALLCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
2530 S COMMERCE ST, ARDMORE, OK 73401-5519
(580) 223-5636
(580) 226-6727
Mailing address
2530 S COMMERCE ST, ARDMORE, OK 73401-5519
(580) 223-5636
(580) 226-6727
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
04/13/2010
Last updated
04/13/2010
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