Provider Demographics
NPI:1922348747
Name:EBELHERR, JULIANN
Entity Type:Individual
Prefix:MS
First Name:JULIANN
Middle Name:
Last Name:EBELHERR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7366 STATE HIGHWAY 79 S
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76310-0454
Mailing Address - Country:US
Mailing Address - Phone:940-733-5347
Mailing Address - Fax:
Practice Address - Street 1:7366 STATE HIGHWAY 79 S
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76310-0454
Practice Address - Country:US
Practice Address - Phone:940-733-5347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68060101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional