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Individual

MS. REBECCA D. EBERLE

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
M.A., CCC-SLP, BC-NC

Contact information

Practice address
200 S JORDAN AVE, DEPARTMENT OF SPEECH AND HEARING SCIENCES, BLOOMINGTON, IN 47405
(812) 855-1069
(812) 855-5561
Mailing address
3918 STONEGATE CT, BLOOMINGTON, IN 47401-9801
(812) 333-4368

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22001596A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11512049
CAQH PROVIDER ID
IN
Enumeration date
10/27/2005
Last updated
07/08/2007
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