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General NPI Number Information
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NPI Number | 1831602622
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Entity Type | Individual
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Provider Name | EMILY C ECKHARDT
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Gender | Female
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Dates
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Enumeration Date | 11/15/2017
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Last Update Date | 12/08/2021
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Provider Practice Location Address
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Address Line | 7108 MARINE RD
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City | EDWARDSVILLE
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State | IL
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Zip | 62025-4282
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Country | US
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Telephone | 618-616-2532
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Fax |
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Provider Business Mailing Address
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Address Line | 1335 STRASSNER DR
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City | BRENTWOOD
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State | MO
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Zip | 63144-1872
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Country | US
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Telephone |
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 146.013895
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 2016021044
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License Number State | MO
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