Individual
DR. KENT ALAN EICHENAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
205 PALMER AVE, BELLEFONTAINE, OH 43311
(937) 206-6500
Mailing address
PO BOX 104, URBANA, OH 43078-0104
(937) 206-6500
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
4151
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0783657
—
OH
01
—
113445
MANAGED HEALTH NETWORK
OH
01
—
3416952163A12
ANTHEM
OH
Enumeration date
12/14/2006
Last updated
12/03/2018
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