Individual
JACOB I MEGDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2422 JOLLY RD, SUITE 300, OKEMOS, MI 48864-3514
(517) 347-6944
(517) 347-6912
Mailing address
PO BOX 10, MASON, MI 48854-0010
(517) 676-9788
(517) 676-3438
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301007262
MI
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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