Provider Demographics
NPI:1144433970
Name:DR JUDY A EAGER LLC
Entity type:Organization
Organization Name:DR JUDY A EAGER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:A
Authorized Official - Last Name:EAGER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:262-785-6003
Mailing Address - Street 1:13965 W BURLEIGH RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-3064
Mailing Address - Country:US
Mailing Address - Phone:262-785-6003
Mailing Address - Fax:262-785-2773
Practice Address - Street 1:13965 W BURLEIGH RD
Practice Address - Street 2:SUITE 203
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-3064
Practice Address - Country:US
Practice Address - Phone:262-785-6003
Practice Address - Fax:262-785-2773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2442-057103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty