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Individual

DR. EBONY DENISE COLEMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
255 N FORBES ST, LAKEPORT, CA 95453-4759
(213) 949-0150
Mailing address
1072 W PEACHTREE ST NW UNIT 7423, ATLANTA, GA 30357-3004
(213) 949-0150

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
103T00000X
Psychologist
103TF0200X
Forensic Psychologist
Primary

Other

Enumeration date
03/28/2019
Last updated
03/28/2019
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