Individual
JOHN A JEROME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
250 E SAGINAW ST, EAST LANSING, MI 48823-2740
(517) 337-3080
(517) 337-3082
Mailing address
250 E SAGINAW ST, EAST LANSING, MI 48823-2740
(517) 337-3080
(517) 337-3082
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301001259
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
680C345670
BLUE CROSS BLUE SHIELD
MI
Enumeration date
07/20/2006
Last updated
07/10/2009
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