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General NPI Number Information
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NPI Number | 1194210583
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Entity Type | Individual
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Provider Name | ALYSSA ANN ECKENRODE LSW
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Gender | Female
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Dates
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Enumeration Date | 06/27/2018
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Last Update Date | 03/07/2022
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Provider Practice Location Address
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Address Line | 1906 N JUNIATA ST
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City | HOLLIDAYSBURG
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State | PA
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Zip | 16648
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Country | US
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Telephone | 814-695-2984
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Fax | 814-695-2110
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Provider Business Mailing Address
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Address Line | 1637 SAINT FRANCIS LN
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City | ALTOONA
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State | PA
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Zip | 16602-7321
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Country | US
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Telephone | 814-932-6070
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW137463
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License Number State | PA
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