| Doctor Name: | DIANE EBERLE |
| NPI Number: | 1932441045 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | CSW09923176 |
| Business Practice Address: | 209 Main Street Unit B Mead, CO - 80542 |
| Business Phone Number: | 3033290870 |
| Business Fax Number: | 3033940871 |
| Mailing Address: | Po Box 177, MEAD |
| State: | CO |
| Postal Code: | 805420177 |
| Phone Number: | 3033290870 |
| Fax Number: | 3033940871 |
| NPI Enumeration Date: | 03/27/2013 |
| NPI Last Update Date: | 11/11/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | CSW09923176 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |