Provider Demographics
NPI:1295587269
Name:EAGER, BROOKE TAYLOR
Entity type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:TAYLOR
Last Name:EAGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:TAYLOR
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 S HOOKER AVE
Mailing Address - Street 2:
Mailing Address - City:THREE RIVERS
Mailing Address - State:MI
Mailing Address - Zip Code:49093-2010
Mailing Address - Country:US
Mailing Address - Phone:269-779-3010
Mailing Address - Fax:
Practice Address - Street 1:306 S LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:THREE RIVERS
Practice Address - State:MI
Practice Address - Zip Code:49093-2022
Practice Address - Country:US
Practice Address - Phone:269-535-9183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-03
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician