Doctor Name: | JACOB MEDDLES |
NPI Number: | 1578959110 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CT |
License Number: | C.1500063-TRNE |
Business Practice Address: | 4760 Madison Rd Cincinnati, OH - 452271426 |
Business Phone Number: | 5133218286 |
Business Fax Number: | 5135335828 |
Mailing Address: | 4760 Madison Rd, CINCINNATI |
State: | OH |
Postal Code: | 452271426 |
Phone Number: | 5133218286 |
Fax Number: | 5135335828 |
NPI Enumeration Date: | 04/10/2015 |
NPI Last Update Date: | 04/10/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | C.1500063-TRNE |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |