Individual
MR. DALE EBORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8500 S. TEN MILE RD, MARYSVALE, UT 84750
(435) 326-4300
(435) 326-4313
Mailing address
8500 S. TEN MILE RD, MARYSVALE, UT 84750
(435) 326-4300
(435) 326-4313
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
253J00000X
Foster Care Agency
—
—
Other
Enumeration date
08/16/2010
Last updated
08/24/2010
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