Individual
EBONY JOLAN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8211 SUMMA AVE, SUITE F, BATON ROUGE, LA 70809
(225) 761-1970
Mailing address
8211 SUMMA AVE, SUITE F, BATON ROUGE, LA 70809-3471
(225) 761-1970
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
11/15/2016
Last updated
05/31/2018
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