Provider Demographics
NPI:1932523453
Name:SPEARS, EBONY E (MA)
Entity Type:Individual
Prefix:
First Name:EBONY
Middle Name:E
Last Name:SPEARS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10100 ELIDA RD
Mailing Address - Street 2:
Mailing Address - City:DELPHOS
Mailing Address - State:OH
Mailing Address - Zip Code:45833-9056
Mailing Address - Country:US
Mailing Address - Phone:419-695-8010
Mailing Address - Fax:419-695-0001
Practice Address - Street 1:5 CENTURY DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-1578
Practice Address - Country:US
Practice Address - Phone:864-250-1601
Practice Address - Fax:864-250-1603
Is Sole Proprietor?:No
Enumeration Date:2014-02-05
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator