Ebon Alley, LICSW

NPI 1265427868 · on the registry since 2005

Practice

Address: 6900 Alden Dr
90 Mdg
Fe Warren Afb, WY 82005
Phone: (307) 773-2998
Fax: (307) 773-4721
Organisation at this address: Dod Fe Warren Pharmacy
Fe Warren Medical Group
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 54

Registry record

Primary taxonomy: 104100000X
104100000X
Licence states on file: MA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2012-03-09

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wyoming