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NPI Code Detail

MEDICARE: MEGHAN TAYLOR JACZKO

MEDICARE: MEGHAN TAYLOR JACZKO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1699503268
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGHAN TAYLOR JACZKO
Provider Business Mailing Address
First Line : 710 PEACHTREE ST NE APT 911
Second Line :
City : ATLANTA
State : GA
Zip : 30308-1222
Country : US
Telephone Number : 908-451-3052
Fax Number :
Provider Business Practice Location Address
First Line : 3232 MEMORIAL DR
Second Line :
City : DECATUR
State : GA
Zip : 30032-3419
Country : US
Telephone Number : 908-451-3052
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2024
Last Update Date : 07/24/2024

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Directions to “ MEGHAN TAYLOR JACZKO ” Practice Location

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