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General NPI Number Information
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NPI Number | 1487085809
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Entity Type | Organization
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Legal Business Name | PALM BEACH PSYCHOLOGY GROUP, LLC
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Dates
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Enumeration Date | 12/11/2013
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Last Update Date | 04/17/2014
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Provider Practice Location Address
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Address Line | 9970 CENTRAL PARK BLVD N SUTIE 207
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City | BOCA RATON
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State | FL
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Zip | 33428-2231
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Country | US
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Telephone | 561-245-4622
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Fax |
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Provider Business Mailing Address
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Address Line | 9970 CENTRAL PARK BLVD N SUTIE 207
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City | BOCA RATON
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State | FL
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Zip | 33428-2231
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Country | US
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Telephone | 561-245-4622
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Fax |
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Authorized Official
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Title or Position | CO-OWNER/ PSYCHOLOGIST
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Name | DR. MEGHAN K JACOBS
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Credential | PSY.D.
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Telephone | 561-245-4622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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