Individual
JACKLYN HOGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8736 MADISON AVE, MUNSTER, IN 46321-2412
(708) 307-4888
Mailing address
9529 MINNICK AVE APT 2N, OAK LAWN, IL 60453-9007
Taxonomy
Speciality
Code
Description
License number
State
224ZF0002X
Feeding, Eating & Swallowing Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
06/05/2017
Last updated
07/16/2020
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