Individual
RAVEN BROOKE ECKHOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPC
Contact information
Practice address
112 N HIGHWAY 5, VERSAILLES, MO 65084
(573) 378-6222
Mailing address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
(417) 761-5065
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2018019069
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490063791
—
MO
Enumeration date
06/12/2018
Last updated
12/21/2022
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