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NPI Code Detail

MEDICARE: JACLYN J OEHLER MS, CCC-SLP

MEDICARE: JACLYN J OEHLER MS, CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist08210MD
2235Z00000XSpeech-Language Pathologist15081NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114369683
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACLYN J OEHLER MS, CCC-SLP
Provider Business Mailing Address
First Line : 3901 WRIGHTSVILLE AVE STE 120
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-6256
Country : US
Telephone Number : 910-679-8385
Fax Number : 910-679-8387
Provider Business Practice Location Address
First Line : 3901 WRIGHTSVILLE AVE STE 120
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-6256
Country : US
Telephone Number : 910-679-8385
Fax Number : 910-679-8387
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2013
Last Update Date : 06/15/2022

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