Provider Demographics
NPI:1649588823
Name:ECKMAN, BARBARA JO (LPN/BHCM)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:JO
Last Name:ECKMAN
Suffix:
Gender:F
Credentials:LPN/BHCM
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:JO
Other - Last Name:KARLOVICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7101 S PRESTON RD
Mailing Address - Street 2:
Mailing Address - City:TISHOMINGO
Mailing Address - State:OK
Mailing Address - Zip Code:73460-4215
Mailing Address - Country:US
Mailing Address - Phone:580-371-8125
Mailing Address - Fax:
Practice Address - Street 1:7101 S PRESTON RD
Practice Address - Street 2:
Practice Address - City:TISHOMINGO
Practice Address - State:OK
Practice Address - Zip Code:73460-4215
Practice Address - Country:US
Practice Address - Phone:580-371-8125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-21
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation