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General NPI Number Information
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NPI Number | 1730970302
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Entity Type | Individual
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Provider Name | MARY EBERLEIN
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Gender | Female
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Dates
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Enumeration Date | 05/14/2025
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 8500 SHOAL CREEK BLVD BLDG 4
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City | AUSTIN
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State | TX
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Zip | 78757-7591
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Country | US
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Telephone | 512-201-4501
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Fax |
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Provider Business Mailing Address
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Address Line | 505 E HUNTLAND DR STE 320
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City | AUSTIN
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State | TX
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Zip | 78752-3741
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Country | US
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Telephone |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 110458
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License Number State | TX
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