Individual
JACLYN J OEHLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
35 REFERENDUM DR NE, BOLIVIA, NC 28422-7578
(910) 406-5100
Mailing address
35 REFERENDUM DR NE, BOLIVIA, NC 28422-7578
(910) 756-5640
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
08210
MD
235Z00000X
Speech-Language Pathologist
Primary
15081
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
844702100
—
MD
Enumeration date
07/24/2013
Last updated
03/31/2026
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