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General NPI Number Information
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NPI Number | 1821195215
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Entity Type | Individual
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Provider Name | F J EICKE ED.D.
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 05/20/2011
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Provider Practice Location Address
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Address Line | 2902 BIENVILLE BLVD SUITE 3
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-4303
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Country | US
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Telephone | 228-818-3280
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Fax |
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Provider Business Mailing Address
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Address Line | 2902 BIENVILLE BLVD, SUITE 3 P. O. BOX 1877
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City | OCEAN SPRINGS
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State | MS
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Zip | 39566-1877
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Country | US
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Telephone | 228-818-3280
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Fax | 228-818-3286
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 19-206
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License Number State | MS
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