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Individual
AMY JAK
Active
Individual
AMY JAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
21113
CA
103TC0700X
Clinical Psychologist
Primary
6301019762
MI
208100000X
Physical Medicine & Rehabilitation Physician
Primary
6301019762
MI
Other
Enumeration date
12/26/2006
Last updated
04/09/2026
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