Doctor Name: | REGINA E ECKLES |
NPI Number: | 1518001734 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | L3859 |
Business Practice Address: | 1000 3rd St Tillamook, OR - 971413430 |
Business Phone Number: | 5038424444 |
Business Fax Number: | 5038152383 |
Mailing Address: | 13010 Highway 101 S, TILLAMOOK |
State: | OR |
Postal Code: | 971418574 |
Phone Number: | 5038421013 |
Fax Number: | 5038152383 |
NPI Enumeration Date: | 02/19/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | L3859 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |