Provider Demographics
NPI:1831351543
Name:EGGERS, DANA JANCIK (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:DANA
Middle Name:JANCIK
Last Name:EGGERS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31231 ROBERTA DR
Mailing Address - Street 2:
Mailing Address - City:BAY VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44140-1561
Mailing Address - Country:US
Mailing Address - Phone:216-410-2879
Mailing Address - Fax:
Practice Address - Street 1:470 CENTER ST
Practice Address - Street 2:BLDG 2
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024-1098
Practice Address - Country:US
Practice Address - Phone:440-478-6192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-25
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP9208235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist