Provider Demographics
NPI:1841201696
Name:EICKHOFF, KRISTINE V (PHD)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:V
Last Name:EICKHOFF
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:
Other - Last Name:CARTWRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8711 WATSON RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63119-5100
Mailing Address - Country:US
Mailing Address - Phone:314-961-9871
Mailing Address - Fax:314-961-9877
Practice Address - Street 1:8711 WATSON RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63119-5100
Practice Address - Country:US
Practice Address - Phone:314-961-9871
Practice Address - Fax:314-961-9877
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01645103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent