Individual
EBONY WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
235 CIVIC CENTER BLVD, HOUMA, LA 70360-5937
(985) 879-3966
Mailing address
1058 E WORTHY ST STE B-2, GONZALES, LA 70737-4359
(225) 450-3216
(225) 450-3799
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
17120
LA
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/19/2022
Last updated
01/16/2026
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