Individual
MRS. MICHALENE MARIE EBBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.,LPC.ALPS.RTT-S
Contact information
Practice address
234 LEE AVE, NITRO, WV 25143-2304
(304) 201-2095
(304) 201-2096
Mailing address
218 D ST, SOUTH CHARLESTON, WV 25303-3104
(304) 201-2095
(304) 204-2096
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
836
WV
Other
Enumeration date
08/25/2015
Last updated
08/25/2015
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