Provider Demographics
NPI:1164295655
Name:SANDERS, EBONEE SYMONE (MS,ALC)
Entity Type:Individual
Prefix:
First Name:EBONEE
Middle Name:SYMONE
Last Name:SANDERS
Suffix:
Gender:F
Credentials:MS,ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 9TH ST
Mailing Address - Street 2:
Mailing Address - City:MIDFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35228-2517
Mailing Address - Country:US
Mailing Address - Phone:205-200-6580
Mailing Address - Fax:
Practice Address - Street 1:105 VULCAN RD STE 300
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-4701
Practice Address - Country:US
Practice Address - Phone:205-200-6580
Practice Address - Fax:888-212-0844
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALALC04616101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor