Individual
MR. JACK MELVIN MERWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYCHOLOGIST
Contact information
Practice address
1100 S PONCE DE LEON BLVD STE 1, SAINT AUGUSTINE, FL 32084-6013
(904) 824-7733
(904) 829-9768
Mailing address
1100 S PONCE DE LEON BLVD STE 1, SAINT AUGUSTINE, FL 32084-6013
(904) 824-7733
(904) 829-9768
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
PY2444
FL
Other
Enumeration date
10/23/2006
Last updated
07/08/2007
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