Individual
RICHARD FRANK ECKERSTORFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1208 SOUTH WATERTOWN STREET, WAUPUN, WI 53963-2309
(920) 324-4358
(920) 324-4737
Mailing address
1208 SOUTH WATERTOWN STREET, WAUPUN, WI 53963-2309
(920) 324-4358
(920) 324-4737
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2801123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39275100
—
WI
Enumeration date
08/16/2006
Last updated
09/10/2007
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