Individual
MARIAN C EBERLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, LCSW
Contact information
Practice address
12612 N BLACK CANYON HWY, PHOENIX, AZ 85029-1345
(623) 252-7433
Mailing address
12612 N BLACK CANYON HWY, PHOENIX, AZ 85029-1345
(623) 252-7433
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-4127
AZ
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN058888
AZ
Other
Enumeration date
10/13/2009
Last updated
11/09/2009
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