Provider Demographics
NPI:1205951225
Name:GAUGER, JACLYN S (MA, CCC-A)
Entity type:Individual
Prefix:
First Name:JACLYN
Middle Name:S
Last Name:GAUGER
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 ROUND HILL RD
Mailing Address - Street 2:CLARKE SCHOOL FOR THE DEAF
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2123
Mailing Address - Country:US
Mailing Address - Phone:412-582-1175
Mailing Address - Fax:413-587-0383
Practice Address - Street 1:45 ROUND HILL RD
Practice Address - Street 2:CLARKE SCHOOL FOR THE DEAF
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2123
Practice Address - Country:US
Practice Address - Phone:412-582-1175
Practice Address - Fax:413-587-0383
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA314231H00000X, 231HA2500X, 231HA2400X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Not Answered231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
Not Answered231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
Not Answered237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA5104441Medicaid
MAGAO39164Medicare ID - Type Unspecified