Individual
EBONY BONNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
7232 JUSTIN WAY, MENTOR, OH 44060-4881
(440) 578-8200
Mailing address
7232 JUSTIN WAY, MENTOR, OH 44060-4881
(440) 578-8200
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
106H00000X
Marriage & Family Therapist
1100670
OH
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
09/26/2019
Last updated
11/29/2021
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