Individual
EBONYE R DILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADAC II
Contact information
Practice address
4065 CANE RIDGE PKWY APT 227, ANTIOCH, TN 37013-4742
(615) 609-1652
Mailing address
PO BOX 22065, NASHVILLE, TN 37202-2065
(615) 434-8195
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1271
TN
Other
Enumeration date
05/04/2022
Last updated
05/04/2022
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