Individual
EBONY NICOLE FAILS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
3131 S STATE ST STE 226, ANN ARBOR, MI 48108-1658
(800) 693-1916
Mailing address
PO BOX 970633, YPSILANTI, MI 48197-0085
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401017673
MI
Other
Enumeration date
09/05/2021
Last updated
01/08/2022
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