Individual
EBONY R DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5422 CRESTA WAY, JACKSONVILLE, FL 32211-5515
(904) 338-1259
(904) 212-2509
Mailing address
PO BOX 2384, JACKSONVILLE, FL 32203-2384
(904) 338-1259
(904) 212-2509
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
15083SW
FL
1041C0700X
Clinical Social Worker
SW15083
FL
Other
Enumeration date
01/26/2018
Last updated
01/26/2018
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