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1750944468
EBONY M MAXIE
HAWTHORNE, CA
NPI
1750944468
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
Enumeration Date
2019-04-18
Last Update Date
2019-11-27
Business Address
EBONY M MAXIE
2501 W EL SEGUNDO BLVD
HAWTHORNE, CA 90250-3317
Phone number: 323-754-2816
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Mailing Address
EBONY M MAXIE
143 E 105TH ST
LOS ANGELES, CA 90003-4726
Phone number: 310-386-7919
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