Provider Demographics
NPI:1194992016
Name:FERMIN, PRISCILLA DEANN (HIS)
Entity type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:DEANN
Last Name:FERMIN
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1812 N HWY 281
Mailing Address - Street 2:
Mailing Address - City:MARBLE FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:78654-4314
Mailing Address - Country:US
Mailing Address - Phone:830-798-2080
Mailing Address - Fax:830-798-2083
Practice Address - Street 1:1812 N HWY 281
Practice Address - Street 2:
Practice Address - City:MARBLE FALLS
Practice Address - State:TX
Practice Address - Zip Code:78654-4314
Practice Address - Country:US
Practice Address - Phone:830-798-2080
Practice Address - Fax:830-798-2083
Is Sole Proprietor?:No
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80281237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist