Doctor Name: | EBONY S MIDDLEBROOK |
NPI Number: | 1063619757 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | B.A. |
License Number: | |
Business Practice Address: | 4401 Crenshaw Blvd 300 Los Angeles, CA - 900431227 |
Business Phone Number: | 3232908360 |
Business Fax Number: | 3232908366 |
Mailing Address: | 4401 Crenshaw Blvd, 300 LOS ANGELES |
State: | CA |
Postal Code: | 900431227 |
Phone Number: | 3232908360 |
Fax Number: | 3232908366 |
NPI Enumeration Date: | 06/27/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Rehabilitation Practitioner |
Taxonomy Specialization: | |
Taxonomy Definition: | A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |