Vanderklok, Regina Jo
Vanderklok, Regina Jo is an sole proprietor health care provider with primary practice located at 4598 Plainfield Ave Ne , Grand Rapids MI 49525-1645. She recently has only one registered license in Speech, Language and Hearing Service Providers / Hearing Instrument Specialist, which is considered as her primary health care specialty. Vanderklok, Regina Jo can be contacted via phone (616) 364-0090.Contact Information
Primary practice address
4598 Plainfield Ave Ne
Grand Rapids MI 49525-1645
Phone: (616) 364-0090
Fax: (616) 364-7441
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Hearing Instrument Specialist | 237700000X | 3501002836 | Michigan |
Profile Details
| NPI number | 1215087762 |
|---|---|
| LBN Legal business name | Vanderklok, Regina Jo |
| Credentials | BC-HIS |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 10th, 2007 |
| Last updated | Feb 2nd, 2017 - about 9 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 | 1215087762 | NPPES |
| Michigan | MEDICAID | 4836981 | |
| Michigan | Other | 540D10522 |
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