Provider Demographics
NPI:1952614539
Name:WEBB, EBONI NICOLE (PSYD, HSP)
Entity Type:Individual
Prefix:DR
First Name:EBONI
Middle Name:NICOLE
Last Name:WEBB
Suffix:
Gender:F
Credentials:PSYD, HSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 COMMERCE ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-3714
Mailing Address - Country:US
Mailing Address - Phone:615-589-1018
Mailing Address - Fax:
Practice Address - Street 1:680 BRICK CHURCH LN
Practice Address - Street 2:
Practice Address - City:WHITES CREEK
Practice Address - State:TN
Practice Address - Zip Code:37189-9184
Practice Address - Country:US
Practice Address - Phone:615-876-3588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-23
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2986103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical