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General NPI Number Information
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NPI Number | 1578750873
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Entity Type | Individual
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Provider Name | MS. LAURA MARIE EBRIGHT
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Gender | Female
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Dates
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Enumeration Date | 10/01/2007
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Last Update Date | 12/02/2016
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Provider Practice Location Address
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Address Line | 134 W SOUTH BOUNDARY ST SUITE MM
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City | PERRYSBURG
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State | OH
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Zip | 43551-1763
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Country | US
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Telephone | 419-873-0891
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Fax | 419-873-0892
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Provider Business Mailing Address
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Address Line | 1428 SILVER PINE LN
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City | FINDLAY
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State | OH
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Zip | 45840-7926
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Country | US
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Telephone | 419-344-5055
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 0602245
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License Number State | OH
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