| Doctor Name: | DR. CLAUDE WAKEFIELD EGGERTSEN |
| NPI Number: | 1235157512 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | |
| Business Practice Address: | 288 S Main St Suite 1 Romeo, MI - 480655133 |
| Business Phone Number: | 2484962871 |
| Business Fax Number: | 5866777809 |
| Mailing Address: | 52976 Westcreek Dr, MACOMB |
| State: | MI |
| Postal Code: | 480422976 |
| Phone Number: | 5866777810 |
| Fax Number: | 5866777809 |
| NPI Enumeration Date: | 07/17/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TB0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Cognitive & Behavioral |
| Taxonomy Definition: | |