Healthcare Provider Details

I. General information

NPI: 1265349690
Provider Name (Legal Business Name): ELIZABETH EGERER MA TLLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17177 N LAUREL PARK DR
LIVONIA MI
48152-2693
US

IV. Provider business mailing address

32831 SUMMERS ST
LIVONIA MI
48154-4141
US

V. Phone/Fax

Practice location:
  • Phone: 734-462-3210
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number6362010309
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: