Individual
DR. MONICA CARLSSON EBAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
412 ELK CIR, BASALT, CO 81621-8202
(970) 927-4945
Mailing address
412 ELK CIR, BASALT, CO 81621-8202
(970) 927-4945
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1480
CO
Other
Enumeration date
03/23/2011
Last updated
03/23/2011
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