Healthcare Provider Details

I. General information

NPI: 1295175941
Provider Name (Legal Business Name): JANET EGGERT PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2013
Last Update Date: 10/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4572 S HAGADORN RD SUITE 3E
EAST LANSING MI
48823-5385
US

IV. Provider business mailing address

PO BOX 10
MASON MI
48854-0010
US

V. Phone/Fax

Practice location:
  • Phone: 517-992-5015
  • Fax:
Mailing address:
  • Phone: 517-676-9788
  • Fax: 517-676-3438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6301013712
License Number StateMI

VIII. Authorized Official

Name: JANET EGGERT
Title or Position: OWNER
Credential: PDH
Phone: 517-282-7598