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NPI Code Detail

MEDICARE: GRACE OLIVIA MAE EBERT

MEDICARE: GRACE OLIVIA MAE EBERT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1457281644
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRACE OLIVIA MAE EBERT
Provider Business Mailing Address
First Line : 901 WHALEN RD
Second Line :
City : VERONA
State : WI
Zip : 53593-1765
Country : US
Telephone Number : 608-229-1643
Fax Number :
Provider Business Practice Location Address
First Line : 901 WHALEN RD
Second Line :
City : VERONA
State : WI
Zip : 53593-1765
Country : US
Telephone Number : 608-229-1643
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2026
Last Update Date : 05/20/2026

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Directions to “ GRACE OLIVIA MAE EBERT ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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