Provider Demographics
NPI:1790829356
Name:EBLE, DANIEL J (MED, PCC)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:J
Last Name:EBLE
Suffix:
Gender:M
Credentials:MED, PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3130 EXECUTIVE PKWY FL 8
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-5530
Mailing Address - Country:US
Mailing Address - Phone:419-720-9000
Mailing Address - Fax:419-720-9002
Practice Address - Street 1:3130 EXECUTIVE PKWY FL 8
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-5530
Practice Address - Country:US
Practice Address - Phone:419-720-9000
Practice Address - Fax:419-720-9002
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0003550101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHE0003550OtherCOUNSELOR LICENSE