Provider Demographics
NPI:1518037894
Name:EBERS, MARY F (OT)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:F
Last Name:EBERS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5930 VANDERVOORT DR STE A
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-2305
Mailing Address - Country:US
Mailing Address - Phone:402-420-2099
Mailing Address - Fax:402-420-2823
Practice Address - Street 1:5930 VANDERVOORT DR STE A
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-2305
Practice Address - Country:US
Practice Address - Phone:402-420-2099
Practice Address - Fax:402-420-2823
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE112225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE9133Medicare UPIN