Ebony Gums's National Provider Identifier (NPI) Details
Ebony Gums, LICSW
NPI: 1841800315
Enumeration Date: 2020-08-08
Last updated: 2020-08-08
Sole Proprietor: NO
Status: active
Postal Address: 515 BEECH ST, WATERLOO, IA
Phone:
Primary Practice Address: 6111 NICOLLET AVE, MINNEAPOLIS, IA
Practice's phone: 612-323-1040