Provider Demographics
NPI:1043312788
Name:MEYERS PROFESSIONAL GROUP
Entity Type:Organization
Organization Name:MEYERS PROFESSIONAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYERS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:412-920-4200
Mailing Address - Street 1:2121 NOBLESTOWN RD
Mailing Address - Street 2:SUITE 21
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15205-3956
Mailing Address - Country:US
Mailing Address - Phone:412-920-4200
Mailing Address - Fax:
Practice Address - Street 1:2121 NOBLESTOWN RD
Practice Address - Street 2:SUITE 21
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15205-3956
Practice Address - Country:US
Practice Address - Phone:412-920-4200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-02
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty