Jacquet, Tara A

Jacquet, Tara A is an individual health care provider with primary practice located at 75 W Commercial St Northeast Hearing And Speech, Suite 205, Portland ME 04101-4797. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Jacquet, Tara A can be contacted via phone (207) 874-1065.

Contact Information

Primary practice address
75 W Commercial St Northeast Hearing And Speech, Suite 205 Portland ME 04101-4797
Phone: (207) 874-1065
Fax: (207) 874-1068
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SP774 Maine

Profile Details

NPI number 1750427639
LBN Legal business name Jacquet, Tara A
Credentials MS CCC SLP
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 29th, 2007
Last updated Oct 20th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750427639 NPPES
Maine Other 024434 ANTHEM BCBS
Maine MEDICAID 269440099 ANTHEM BCBS

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