| Miss Ebony Lpc | |
|
1024 Heriott St Manning SC 29102-5919 | |
| (803) 339-2221 | |
| Not Available |
| Full Name | Miss Ebony Lpc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 1024 Heriott St, Manning, South Carolina |
| Authorized Official Name and Position | Ebony Langhorne (OWNER) |
| Authorized Official Contact | 8033392221 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Miss Ebony Lpc 1024 Heriott St Manning SC 29102-5919 Ph: (803) 339-2221 | Miss Ebony Lpc 1024 Heriott St Manning SC 29102-5919 Ph: (803) 339-2221 |
| NPI Number | 1063275972 |
|---|---|
| Provider Enumeration Date | 02/02/2024 |
| Last Update Date | 02/08/2024 |
| Certification Date | 02/08/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063275972 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
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