Individual
ELIZABETH EBNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
820 PASEO DE PERALTA, SANTA FE, NM 87501-2233
(505) 992-3117
(505) 820-1209
Mailing address
4 RECADO RD, SANTA FE, NM 87508-1917
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
00880081
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77325354
—
NM
Enumeration date
07/17/2006
Last updated
07/09/2007
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