Individual
MISS EBONI CHAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-P
Contact information
Practice address
8382 SIX FORKS RD, SUITE 102, RALEIGH, NC 27615-5080
(919) 747-9239
Mailing address
8382 SIX FORKS RD, SUITE 102, RALEIGH, NC 27615-5080
(919) 747-9239
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P006564
NC
Other
Enumeration date
07/12/2012
Last updated
07/12/2012
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