Provider Demographics
NPI:1073673620
Name:ECKHAUS, DIANA MILLER (MSW)
Entity Type:Individual
Prefix:MS
First Name:DIANA
Middle Name:MILLER
Last Name:ECKHAUS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 ST LAWRENCE WAY
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-1271
Mailing Address - Country:US
Mailing Address - Phone:732-536-4098
Mailing Address - Fax:
Practice Address - Street 1:45 ST LAWRENCE WAY
Practice Address - Street 2:
Practice Address - City:MARLBORO
Practice Address - State:NJ
Practice Address - Zip Code:07746-1271
Practice Address - Country:US
Practice Address - Phone:732-536-4098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC045197001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical