Individual
DR. ERIC DAVID HENEKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
3851 ROGER BROOKE DR # DRIVE-QD, FORT SAM HOUSTON, TX 78234-4501
(813) 892-4197
Mailing address
6900 SOUTHPOINT DR N, JACKSONVILLE, FL 32216-8007
(904) 470-6900
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
567
WY
103TC0700X
Clinical Psychologist
WY567
WY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/18/2012
Last updated
04/15/2021
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