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Individual

TIFFANY MAXWELL EBERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
HC 60 BOX 2470, HAWORTH, OK 74740-9675
(580) 212-9925
Mailing address
HC 60 BOX 2470, HAWORTH, OK 74740-9675
(580) 212-9925

Taxonomy

Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
Primary

Other

Enumeration date
12/08/2008
Last updated
04/10/2009
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