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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215087762 NPPES
Michigan MEDICAID 4836981
Michigan Other 540D10522

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