Individual
MICHELLE D EAGLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
6630 MANISTEE ST, FREDERIC, MI 49733-9760
(989) 889-0100
Mailing address
6630 MANISTEE ST, FREDERIC, MI 49733-9760
(989) 889-0100
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401222540
MI
101YP2500X
Professional Counselor
6401015744
MI
Other
Enumeration date
11/17/2016
Last updated
05/31/2022
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