Individual
LAURA W. ECKHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
442 W HIGH ST, BRYAN, OH 43506-1681
(419) 636-4517
(419) 636-6438
Mailing address
442 W HIGH ST, BRYAN, OH 43506-1681
(419) 636-4517
(419) 636-6438
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
5681
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2387715
—
OH
Enumeration date
03/14/2007
Last updated
07/08/2007
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