| NPI | 1770772097 |
|---|---|
| Other Name | EBONY MONIQUE SHELTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: TX 2016-049364-001B) |
| Additional Taxonomies | 104100000X Social Worker (Licence: TX 60555) |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2019-01-08 |