Provider Demographics
NPI:1316982432
Name:EBERHART, TERESA J (CTRS)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:J
Last Name:EBERHART
Suffix:
Gender:F
Credentials:CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:539 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-2208
Mailing Address - Country:US
Mailing Address - Phone:719-251-6935
Mailing Address - Fax:
Practice Address - Street 1:539 E 5TH ST
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-2208
Practice Address - Country:US
Practice Address - Phone:719-251-6935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-20
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist