Individual
MRS. HEATHER ANN EBERTH-TEIKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34005203A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000337429
ANTHEM PIN
IN
05
—
100177270A
—
IN
01
—
732461000
MAGELLAN PIN
IN
Enumeration date
10/12/2006
Last updated
05/06/2008
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