Provider Demographics
NPI:1710298682
Name:CARSONPINKNEY, EBONY (DPT)
Entity Type:Individual
Prefix:
First Name:EBONY
Middle Name:
Last Name:CARSONPINKNEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9420 KEY WEST AVE
Mailing Address - Street 2:SUITE 140
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3334
Mailing Address - Country:US
Mailing Address - Phone:301-545-1677
Mailing Address - Fax:301-545-1675
Practice Address - Street 1:9420 KEY WEST AVE
Practice Address - Street 2:SUITE 140
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3334
Practice Address - Country:US
Practice Address - Phone:301-545-1677
Practice Address - Fax:301-545-1675
Is Sole Proprietor?:No
Enumeration Date:2010-06-25
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23308225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist