Provider Demographics
NPI:1801934104
Name:ECKERY, CHRISTINE LYNNE (MA, LMT, CPT)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:LYNNE
Last Name:ECKERY
Suffix:
Gender:F
Credentials:MA, LMT, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 PRESIDENTIAL DRIVE
Mailing Address - Street 2:SUITE 003
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19807-3366
Mailing Address - Country:US
Mailing Address - Phone:302-593-9262
Mailing Address - Fax:302-635-1799
Practice Address - Street 1:230 PRESIDENTIAL DRIVE
Practice Address - Street 2:SUITE 003
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19807
Practice Address - Country:US
Practice Address - Phone:302-593-9262
Practice Address - Fax:302-635-1799
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
DEMT-0002380225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0256047564OtherANTHEM BCBS