Provider Demographics
NPI:1487744231
Name:ECKHART, RESA KAY
Entity type:Individual
Prefix:
First Name:RESA
Middle Name:KAY
Last Name:ECKHART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:673 HELMS ORANGE DR
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:IN
Mailing Address - Zip Code:46783-8878
Mailing Address - Country:US
Mailing Address - Phone:260-403-0732
Mailing Address - Fax:
Practice Address - Street 1:2821 HILLEGAS RD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46808-3859
Practice Address - Country:US
Practice Address - Phone:260-471-1950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist