Individual
GABRIELLE EBERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
55 FODEN RD, SOUTH PORTLAND, ME 04106-1717
(207) 854-1030
Mailing address
55 FODEN RD, SOUTH PORTLAND, ME 04106-1717
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MC22152
ME
Other
Enumeration date
07/14/2023
Last updated
07/14/2023
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