Individual
MR. ROBERT LEWIS EGGLESTON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LLPC
Contact information
Practice address
741 KENMOOR AVE SE STE B, GRAND RAPIDS, MI 49546-2304
(616) 425-2412
Mailing address
926 COLUMBUS AVE, GRAND HAVEN, MI 49417-1500
(616) 635-7467
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401018202
MI
101YP2500X
Professional Counselor
6401018202
MI
Other
Enumeration date
04/30/2020
Last updated
04/30/2020
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