Individual
MADISON MAE EBELING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4200 MERCHANT ST STE 103, COLUMBIA, MO 65203-5816
(573) 777-8783
Mailing address
4200 MERCHANT ST STE 103, COLUMBIA, MO 65203-5816
(573) 777-8783
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2023039468
MO
Other
Enumeration date
10/09/2023
Last updated
10/09/2023
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