Individual
DR. JACOB JOHN MAHON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD; BCBA-D
Contact information
Practice address
1744 E MCANDREWS RD STE B, MEDFORD, OR 97504-5576
(541) 654-1776
Mailing address
1744 E MCANDREWS RD STE B, MEDFORD, OR 97504-5576
(541) 776-0821
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3067
OR
103TH0100X
Health Service Psychologist
3067
OR
Other
Enumeration date
01/06/2009
Last updated
08/16/2019
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