Knobloch, Jacquelyn B
Knobloch, Jacquelyn B is an individual health care provider with primary practice located at 8583 Dynasty Dr , Boca Raton FL 33433-6823. She recently has 2 registered licenses in different health care specialties including Speech, Language and Hearing Service Providers / Speech-Language Pathologist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist. Speech, Language and Hearing Service Providers / Speech-Language Pathologist is her primary health care specialty. Knobloch, Jacquelyn B can be contacted via phone (585) 797-8937.Contact Information
Primary practice address
8583 Dynasty Dr
Boca Raton FL 33433-6823
Phone: (585) 797-8937
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | SA 9838 | Florida |
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | 018660-1 | New York |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist | 222Q00000X | SA9838 | Florida |
Profile Details
| NPI number | 1356464606 |
|---|---|
| LBN Legal business name | Knobloch, Jacquelyn B |
| Credentials | M.A., CCC-SLP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 9th, 2007 |
| Last updated | Jul 31st, 2014 - about 11 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 | 1356464606 | NPPES |
| Florida | MEDICAID | 000816100 | |
| Florida | MEDICAID | 003772200 |
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