Sample, Jacquelyn
Sample, Jacquelyn is an individual health care provider with primary practice located at 300 Portland Street , Columbia MO 65202. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Sample, Jacquelyn can be contacted via phone (573) 882-3757.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | 004712 | Missouri |
Profile Details
| NPI number | 1568509867 |
|---|---|
| LBN Legal business name | Sample, Jacquelyn |
| Credentials | MED OTRL |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 30th, 2007 |
| Last updated | Aug 7th, 2009 - about 16 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 | 1568509867 | NPPES |
| Mississippi | MEDICAID | 476068812 |
Popular Providers
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