Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 07-29P | AR |
Y | 103TC0700X | Clinical Psychologist | 07-29P | AR |
NPI | 1003901604 |
---|---|
Provider Name | Dr. Kristen W Eckelhoff |
First Address | Fort Smith, AR 72903 |
Second Address | Fort Smith, AR 72903 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 18/09/2020 |