Organization
EXPANSION GUIDANCE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EBONI R. HENRY LPC (PROVIDER/THERAPIST)
(770) 609-1973
Entity
Organization
Contact information
Practice address
760 OLD ROSWELL RD STE 208, ROSWELL, GA 30076-8686
(770) 609-1973
(770) 545-8630
Mailing address
760 OLD ROSWELL RD STE 208, ROSWELL, GA 30076-8686
(770) 609-1973
(770) 545-8630
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
006759
GA
Other
Enumeration date
11/22/2017
Last updated
11/25/2017
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