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Individual

DR. DEBORAH EBENER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
1114 W CALL ST STE 3210, TALLAHASSEE, FL 32306-1766
(850) 644-3611
Mailing address
1114 W CALL ST STE 3210, TALLAHASSEE, FL 32304-3476
(850) 644-3611

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY5093
FL
103TA0700X
Adult Development & Aging Psychologist
PY5093
FL
103TC1900X
Counseling Psychologist
103TC2200X
Clinical Child & Adolescent Psychologist
PY5093
FL
103TM1800X
Intellectual & Developmental Disabilities Psychologist
103TR0400X
Rehabilitation Psychologist
PY5093
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
59612
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/01/2006
Last updated
12/02/2024
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