Doctor Name: | EBONY L. WINGER |
NPI Number: | 1093085540 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LSW |
License Number: | SW128530 |
Business Practice Address: | 456 N Pitt St Mercer, PA - 161371129 |
Business Phone Number: | 7246627202 |
Business Fax Number: | 7246627208 |
Mailing Address: | 1582 Barkeyville Rd, GROVE CITY |
State: | PA |
Postal Code: | 161277902 |
Phone Number: | 7249929931 |
Fax Number: | |
NPI Enumeration Date: | 12/30/2011 |
NPI Last Update Date: | 12/30/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | SW128530 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |