Provider Demographics
NPI:1184932212
Name:BACHMAN, JANE (AUD)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:BACHMAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:
Other - Last Name:OLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:400 MEDICAL PARK DR STE LL1
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:OH
Mailing Address - Zip Code:44622-3207
Mailing Address - Country:US
Mailing Address - Phone:330-364-2700
Mailing Address - Fax:
Practice Address - Street 1:400 MEDICAL PARK DR STE LL1
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:OH
Practice Address - Zip Code:44622-3207
Practice Address - Country:US
Practice Address - Phone:330-364-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-23
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH01771231H00000X
KY0531231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist