Individual
EBONI SHARAI LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6110 SHALLOWFORD RD STE B, CHATTANOOGA, TN 37421-1894
(423) 304-1202
Mailing address
3508 OHLS AVE, CHATTANOOGA, TN 37410-1340
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
TN
Other
Enumeration date
06/08/2017
Last updated
06/08/2017
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