Provider Demographics
NPI:1962502328
Name:EGGIMAN, JANET M (LMFT)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:M
Last Name:EGGIMAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10319 DAWSONS CREEK BLVD
Mailing Address - Street 2:STE. J
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825-1911
Mailing Address - Country:US
Mailing Address - Phone:260-969-5583
Mailing Address - Fax:260-969-5584
Practice Address - Street 1:10319 DAWSONS CREEK BLVD
Practice Address - Street 2:STE. J
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-1911
Practice Address - Country:US
Practice Address - Phone:260-969-5583
Practice Address - Fax:260-969-5584
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35001565A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN7585825OtherAETNA
IN386107OtherANTHEM