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Individual

EBONY THOMAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
23560 FDR BLVD, #402, CALIFORNIA, MD 20619
(240) 925-1801
Mailing address
18490 MATTHEWS DR, LEXINGTON PARK, MD 20653-3573
(832) 530-2674

Taxonomy

Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary

Other

Enumeration date
10/04/2019
Last updated
10/04/2019
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