NPI 1144717604

Jaclyn Reckow, PHD

Practitioner Clinical Neuropsychologist Grand Rapids, MI

Practice location

Address: 245 Cherry St SE STE 104, Grand Rapids, MI 49503-4607
Phone: (616) 685-5050
Fax: (616) 685-8962
Mailing address: 1900 44th St SE, Kentwood, MI 49508-5008

Registered specialties

Clinical Neuropsychologist Primary

Behavioral Health & Social Service Providers Taxonomy 103G00000X Licence 6301016942 (MI)

Other Clinical Neuropsychologist providers in Michigan →

Registry record

NPI: 1144717604
Entity type: Individual
Sex (as registered): Female
NPI issued: 19 Apr 2018
Record last updated: 19 Apr 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.