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General NPI Number Information
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NPI Number | 1336277649
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Entity Type | Individual
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Provider Name | ALYCE M. ELBERN PH.D.
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Gender | Female
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 108 SOUTH HEATHER LN
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City | COLUMBIA
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State | MO
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Zip | 65203-7640
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Country | US
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Telephone | 573-446-8990
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Fax | 573-445-9090
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Provider Business Mailing Address
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Address Line | 108 HEATHER LN
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City | COLUMBIA
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State | MO
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Zip | 65203-7640
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Country | US
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Telephone | 573-446-8990
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Fax | 573-445-9090
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 940
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 730
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License Number State | OK
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