Individual
EBONY R SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14011 WORTH AVE, WOODBRIDGE, VA 22192-4123
(703) 792-4900
Mailing address
4308 GEORGE FRYE CIR, WOODBRIDGE, VA 22193-5774
(760) 717-0319
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701015335
VA
Other
Enumeration date
09/22/2025
Last updated
12/04/2025
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