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
Fax: (219) 756-7825
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972670636 NPPES
Indiana MEDICAID 100466390A

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