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Individual

JACLIN K PROCTOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A., CCC-A

Contact information

Practice address
99 E 86TH AVE, SUITE A, MERRILLVILLE, IN 46410-6381
(219) 738-2528
(219) 756-7825
Mailing address
99 E 86TH AVE, SUITE A, MERRILLVILLE, IN 46410-6381
(219) 738-2528
(219) 756-7825

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
23000412A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100466390A
IN
Enumeration date
11/29/2006
Last updated
01/11/2008
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