Individual
MRS. GRETCHEN ANNE EBELT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW,LCSW
Contact information
Practice address
1325 ANGELS PATH, DE PERE, WI 54115-4050
(920) 338-2855
(920) 403-7360
Mailing address
PO BOX 22040, GREEN BAY, WI 54305-2040
(920) 445-7222
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7864-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265765564
—
WI
Enumeration date
09/17/2009
Last updated
11/23/2020
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