Individual
MAURA EAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
765 PIERCE DR, COLUMBUS, OH 43223-2425
(614) 223-1650
Mailing address
PO BOX 715194, COLUMBUS, OH 43271-5194
(614) 355-8004
(614) 355-2220
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
E.2001615
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2846675
—
OH
Enumeration date
09/18/2013
Last updated
01/27/2020
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