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1881250934
EBONY NICHOLE BLUE
LOS ANGELES, CA
NPI
1881250934
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2019-05-14
Last Update Date
2019-05-14
Business Address
EBONY NICHOLE BLUE
2116 S CENTRAL AVE
LOS ANGELES, CA 90011-1237
Phone number: 213-493-4664
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Mailing Address
EBONY NICHOLE BLUE
11601 FIRESTONE BLVD APT 312
NORWALK, CA 90650-8826
Phone number: 424-356-3301
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