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General NPI Number Information
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NPI Number | 1093811010
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Entity Type | Individual
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Provider Name | ELIZABETH A EBER PH.D.
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Gender | Female
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 10/25/2024
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Provider Practice Location Address
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Address Line | 195 CANAL ST
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City | MALDEN
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State | MA
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Zip | 02148-6701
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Country | US
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Telephone | 215-247-4854
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Fax | 215-247-4857
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Provider Business Mailing Address
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Address Line | 80 PARK ST APT 44
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City | BROOKLINE
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State | MA
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Zip | 02446-6314
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Country | US
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Telephone | 610-256-7330
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS008896L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY11802
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License Number State | MA
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