Individual
TONYA JIVIDEN EBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25 SUNSHINE CT, DURANGO, CO 81301-6023
(970) 375-1580
Mailing address
25117 SW PARKWAY AVE, WILSONVILLE, OR 97070-9697
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
3786
NM
225X00000X
Occupational Therapist
Primary
OT.0005122
CO
Other
Enumeration date
09/11/2017
Last updated
09/11/2017
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