Provider Demographics
NPI:1295508638
Name:EBONY SPEAKES-HALL
Entity type:Organization
Organization Name:EBONY SPEAKES-HALL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EBONY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPEAKES-HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-360-1235
Mailing Address - Street 1:6617 ENGLISH OAKS STA
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45044-9262
Mailing Address - Country:US
Mailing Address - Phone:937-360-1235
Mailing Address - Fax:
Practice Address - Street 1:9078 UNION CENTRE BLVD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-4991
Practice Address - Country:US
Practice Address - Phone:513-966-4402
Practice Address - Fax:513-586-0255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-06
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty