Provider Demographics
NPI:1366608820
Name:ECKARD, ANDREA DAWN (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:DAWN
Last Name:ECKARD
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 QUAIL CREST DR
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-1755
Mailing Address - Country:US
Mailing Address - Phone:901-651-8964
Mailing Address - Fax:901-861-5083
Practice Address - Street 1:611 QUAIL CREST DR
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-1755
Practice Address - Country:US
Practice Address - Phone:901-651-8964
Practice Address - Fax:901-861-5083
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3388235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist