Provider Demographics
NPI:1447308978
Name:MEYER, GREGORY J (PHD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:J
Last Name:MEYER
Suffix:
Gender:M
Credentials:PHD
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Other - Credentials:
Mailing Address - Street 1:2801 W BANCROFT ST
Mailing Address - Street 2:U OF TOLEDO, PSYCHOLOGY, MAIL STOP 948
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-3328
Mailing Address - Country:US
Mailing Address - Phone:419-530-4312
Mailing Address - Fax:419-530-8479
Practice Address - Street 1:2801 W BANCROFT ST
Practice Address - Street 2:U OF TOLEDO, PSYCHOLOGY, MAIL STOP 948
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3328
Practice Address - Country:US
Practice Address - Phone:419-530-4312
Practice Address - Fax:419-530-8479
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6076103TC0700X
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical