| Coram Consulting Llc | |
|
431 S Main St Ste 6 Rice Lake WI 54868-2241 | |
| (715) 931-0317 | |
| Not Available |
| Full Name | Coram Consulting Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 431 S Main St Ste 6, Rice Lake, Wisconsin |
| Authorized Official Name and Position | Amber G Ebert (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 7159310317 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coram Consulting Llc 904 N 2nd St Ste C Cameron WI 54822-7736 Ph: (715) 931-0317 | Coram Consulting Llc 431 S Main St Ste 6 Rice Lake WI 54868-2241 Ph: (715) 931-0317 |
| NPI Number | 1427596121 |
|---|---|
| Provider Enumeration Date | 02/02/2017 |
| Last Update Date | 07/26/2023 |
| Certification Date | 07/26/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427596121 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 2862-57 (Wisconsin) | Primary |
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