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General NPI Number Information
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NPI Number | 1811279045
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Entity Type | Individual
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Provider Name | ERALPHIA LEE ECKLES JR. LBSW
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Gender | Male
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Dates
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Enumeration Date | 09/14/2011
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Last Update Date | 09/14/2011
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Provider Practice Location Address
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Address Line | 1022 RODA DR.
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City | FLORENCE
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State | SC
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Zip | 29501
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Country | US
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Telephone | 843-229-1905
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Fax | 843-665-8565
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Provider Business Mailing Address
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Address Line | 1022 RODA DR.
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City | FLORENCE
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State | SC
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Zip | 29501
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Country | US
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Telephone | 843-229-1905
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Fax | 843-665-8565
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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 | 3123
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License Number State | SC
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