EBONIE WALLACE

DAYTONA BEACH, FL
NPI1871044255
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2016-10-20
Last Update Date2021-02-18
Business Address
EBONIE WALLACE
140 S BEACH ST STE 310
DAYTONA BEACH, FL 32114-4409
Phone number: 386-898-6040
Mailing Address
EBONIE WALLACE
140 S BEACH ST
DAYTONA BEACH, FL 32114-4472
Phone number: 386-898-6040