Provider Demographics
NPI:1255594438
Name:EGAN, JEAN (CFLE)
Entity type:Individual
Prefix:DR
First Name:JEAN
Middle Name:
Last Name:EGAN
Suffix:
Gender:F
Credentials:CFLE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 WOODS HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:WEST SUFFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06093-2656
Mailing Address - Country:US
Mailing Address - Phone:860-668-4466
Mailing Address - Fax:860-668-1474
Practice Address - Street 1:33 WOODS HOLLOW RD
Practice Address - Street 2:
Practice Address - City:WEST SUFFIELD
Practice Address - State:CT
Practice Address - Zip Code:06093-2656
Practice Address - Country:US
Practice Address - Phone:860-668-4466
Practice Address - Fax:860-668-1474
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor