Individual
RAVEN EBONI JENERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
3480 PRESTON RIDGE RD STE 500, ALPHARETTA, GA 30005-5460
(404) 969-6116
Mailing address
3480 PRESTON RIDGE RD STE 500, ALPHARETTA, GA 30005-5460
(404) 969-6116
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
0904015007
VA
1041C0700X
Clinical Social Worker
Primary
LC50082869
DC
Other
Enumeration date
05/10/2021
Last updated
06/01/2023
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