Basic Information
| Provider Information | |||||||||
| NPI: | 1144433970 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DR JUDY A EAGER LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13965 W BURLEIGH RD | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | BROOKFIELD | ||||||||
| State: | WI | ||||||||
| PostalCode: | 530053064 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2627856003 | ||||||||
| FaxNumber: | 2627852773 | ||||||||
| Practice Location | |||||||||
| Address1: | 13965 W BURLEIGH RD | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | BROOKFIELD | ||||||||
| State: | WI | ||||||||
| PostalCode: | 530053064 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2627856003 | ||||||||
| FaxNumber: | 2627852773 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | EAGER | ||||||||
| AuthorizedOfficialFirstName: | JUDY | ||||||||
| AuthorizedOfficialMiddleName: | A. | ||||||||
| AuthorizedOfficialTitleorPosition: | CLINICAL PSYCHOLOGIST | ||||||||
| AuthorizedOfficialTelephone: | 2627856003 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | PSY.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 2442-057 | WI | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.