Individual
DR. JEFFREY T FEATHERGILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
211 W WASHINGTON ST STE 2311, SOUTH BEND, IN 46601-1708
(574) 282-1090
(866) 540-3094
Mailing address
211 W WASHINGTON ST STE 2311, SOUTH BEND, IN 46601-1708
(574) 282-1090
(866) 540-3094
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
20041616A
IN
103TA0400X
Addiction (Substance Use Disorder) Psychologist
20041616A
IN
103TA0700X
Adult Development & Aging Psychologist
20041616A
IN
103TC0700X
Clinical Psychologist
Primary
20041616A
IN
Other
Enumeration date
06/28/2006
Last updated
01/23/2012
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