| Doctor Name: | MRS. ANGELIQUE CECIEL EBERWEIN |
| NPI Number: | 1629300389 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.T., C.N.M.T |
| License Number: | 3041 |
| Business Practice Address: | 7075 Campus Dr Suite #210 Colorado Springs, CO - 809206523 |
| Business Phone Number: | 7193226778 |
| Business Fax Number: | 7193442295 |
| Mailing Address: | 510 E Yampa St, COLORADO SPRINGS |
| State: | CO |
| Postal Code: | 809032939 |
| Phone Number: | 7193226778 |
| Fax Number: | 7193442295 |
| NPI Enumeration Date: | 02/05/2010 |
| NPI Last Update Date: | 02/05/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225700000X |
| License Number: | 3041 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Massage Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |