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1487041026
EBONY NICOLE MCENNIS
SAN BERNARDINO, CA
NPI
1487041026
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2015-04-21
Last Update Date
2015-04-21
Business Address
-- EBONY NICOLE MCENNIS
1950 S SUNWEST LN
SAN BERNARDINO, CA 92408-3258
Phone number: 909-252-4010
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Mailing Address
-- EBONY NICOLE MCENNIS
15395 SHEILA ST APARTMENT A
MORENO VALLEY, CA 92551-4551
Phone number: 951-488-4726
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