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General NPI Number Information
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NPI Number | 1750954350
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Entity Type | Organization
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Legal Business Name | JACLYN MALEK MA PLLC
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Dates
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Enumeration Date | 07/21/2021
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Last Update Date | 07/21/2021
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Provider Practice Location Address
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Address Line | 900 W UNIVERSITY DR
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City | ROCHESTER
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State | MI
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Zip | 48307-1817
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Country | US
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Telephone | 248-225-5690
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Fax |
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Provider Business Mailing Address
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Address Line | 507 E UNIVERSITY DR APT 405
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City | ROCHESTER
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State | MI
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Zip | 48307-2158
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Country | US
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Telephone | 248-225-5690
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | JACLYN MALEK
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Credential | MA, LPC
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Telephone | 248-225-5690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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