Organization
LIFE BALANCE THERAPY, LLC
Active
Other names
Ebony Bailey
Organization subpart
No
Provider details
NPI number
Authorized official
EBONY BAILEY MA, LPC-MHSP (OWNER/PSYCHOTHERAPY)
(901) 598-2431
Entity
Organization
Contact information
Practice address
5865 RIDGEWAY CENTER PKWY STE 300, MEMPHIS, TN 38120-4014
(901) 598-2431
Mailing address
313 LOONEY AVE, MEMPHIS, TN 38107-3790
(901) 598-2431
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
0000002511
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2511
INSTAMED
TN
Enumeration date
12/06/2011
Last updated
04/08/2022
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