Proctor, Jaclin K
Proctor, Jaclin K is an sole proprietor health care provider with primary practice located at 99 E 86Th Ave Suite A, Merrillville IN 46410-6381. She recently has only one registered license in Speech, Language and Hearing Service Providers / Audiologist, which is considered as her primary health care specialty. Proctor, Jaclin K can be contacted via phone (219) 738-2528.Contact Information
Primary practice address
99 E 86Th Ave Suite A
Merrillville IN 46410-6381
Phone: (219) 738-2528
Fax: (219) 756-7825
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Audiologist | 231H00000X | 23000412A | Indiana |
Profile Details
| NPI number | 1972670636 |
|---|---|
| LBN Legal business name | Proctor, Jaclin K |
| Credentials | M.A., CCC-A |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 29th, 2006 |
| Last updated | Jan 11th, 2008 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972670636 | NPPES |
| Indiana | MEDICAID | 100466390A |
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