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NPI Code Detail

MEDICARE: ELLORA MAYERL

MEDICARE: ELLORA MAYERL
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
1101YP2500XProfessional Counselor7993-226WI

General Provider Information

NPI Number : 1467282046
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLORA MAYERL
Provider Business Mailing Address
First Line : 1721 SAEMANN AVE
Second Line :
City : SHEBOYGAN
State : WI
Zip : 53081-2342
Country : US
Telephone Number : 920-783-6633
Fax Number :
Provider Business Practice Location Address
First Line : 1721 SAEMANN AVE
Second Line :
City : SHEBOYGAN
State : WI
Zip : 53081-2342
Country : US
Telephone Number : 920-783-6633
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2024
Last Update Date : 04/07/2026

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Directions to “ ELLORA MAYERL ” Practice Location

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