Individual
EBONI NICOEL ISAACS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HLP
Contact information
Practice address
11711 PRINCETON PIKE, SPRINGDALE, OH 45246-2534
(513) 608-6599
Mailing address
15 VALE AVE APT 7, WYOMING, OH 45215-2160
(513) 608-6599
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
COSA.980771
OH
Other
Enumeration date
10/05/2023
Last updated
10/05/2023
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