| Doctor Name: | EBONI HENRY |
| NPI Number: | 1154755601 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LGSW |
| License Number: | 17902 |
| Business Practice Address: | 411 Warfield Dr Apt 3008 Landover, MD - 207855524 |
| Business Phone Number: | 7063406521 |
| Business Fax Number: | |
| Mailing Address: | 411 Warfield Dr, Apt 3008 LANDOVER |
| State: | MD |
| Postal Code: | 207855524 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 09/02/2013 |
| NPI Last Update Date: | 09/02/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 17902 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |