JAMILA EBONY PROVITT

WARREN, OH
NPI1700366614
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy104100000X Social Worker
(Licence: OH  S.1904129)
Additional Taxonomies1041C0700X Social Worker, Clinical
Enumeration Date2018-08-20
Last Update Date2020-02-20
Business Address
JAMILA EBONY PROVITT LSW, BA, MSW
2671 YOUNGSTOWN RD SE
WARREN, OH 44484-4404
Phone number: 330-469-9743
Mailing Address
JAMILA EBONY PROVITT LSW, BA, MSW
8261 MARKET ST
BOARDMAN, OH 44512-6254
Phone number: 330-286-0050