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Individual

MRS. JOANNE MARIE EBERWEIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS,OTR

Contact information

Practice address
11845 GONTRUM RD, KINGSVILLE, MD 21087-1356
(410) 817-4165
(410) 222-6916
Mailing address
11845 GONTRUM RD, KINGSVILLE, MD 21087-1356
(410) 817-4165
(410) 222-6916

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
01697
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0902
MD
Enumeration date
02/22/2007
Last updated
07/08/2007
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