Doctor Name: | JENNIFER EBERLE |
NPI Number: | 1184903544 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 694-8-1-11A |
Business Practice Address: | 150 2nd St Sw #1 Valley City, ND - 580723302 |
Business Phone Number: | 7014903281 |
Business Fax Number: | |
Mailing Address: | 150 2nd St Sw, #1 VALLEY CITY |
State: | ND |
Postal Code: | 580723302 |
Phone Number: | 7014903281 |
Fax Number: | 7014903283 |
NPI Enumeration Date: | 08/16/2011 |
NPI Last Update Date: | 08/31/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 694-8-1-11A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ND |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |