Provider Demographics
NPI:1942757315
Name:FITCHUE, EBONY
Entity Type:Individual
Prefix:MS
First Name:EBONY
Middle Name:
Last Name:FITCHUE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2022 FLAGLER PL NW APT F101
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-5623
Mailing Address - Country:US
Mailing Address - Phone:215-688-7263
Mailing Address - Fax:
Practice Address - Street 1:425 C ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-5817
Practice Address - Country:US
Practice Address - Phone:215-688-7263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-02
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool