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1790204980
EBONY MICHELLE SMITH
STOCKTON, CA
NPI
1790204980
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2017-09-19
Last Update Date
2017-09-19
Business Address
EBONY MICHELLE SMITH
6851 PLYMOUTH RD APT 24
STOCKTON, CA 95207-2321
Phone number: 209-210-7079
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Mailing Address
EBONY MICHELLE SMITH
1111 N EL DORADO ST
STOCKTON, CA 95202-1305
Phone number: 209-938-0228
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