MS. Ebony Waller, LMFT, RPT, PHD
NPI #1982431094 in Cherry Valley, Illinois
Provider Information
- NPI Number
- 1982431094
- Entity Type
- Individual
- Name
- MS. Ebony Waller, LMFT, RPT, PHD
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Marriage & Family Therapist
- Credential
- LMFT, RPT, PHD
- Enumeration Date
- Sep 14, 2024
- Last Updated
- Sep 14, 2024
Practice Location
- Address
- 7572 N CHERRYVALE BLVD APT 204
- City
- Cherry Valley
- State
- Illinois
- ZIP Code
- 61016-9305
- Phone
- (702) 572-8535
Specialties & Taxonomy Codes
| Specialty |
|---|
| Marriage & Family Therapist |
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