Doctor Name: | TIMOTHY JASON WILLETT |
NPI Number: | 1114261021 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | H.A.S. |
License Number: | AS 4908 |
Business Practice Address: | 1615 Ridgewood Ave # B Holly Hill, FL - 321171798 |
Business Phone Number: | 3866733366 |
Business Fax Number: | 3866150990 |
Mailing Address: | 1615 Ridgewood Ave # B, HOLLY HILL |
State: | FL |
Postal Code: | 321171798 |
Phone Number: | 3866733366 |
Fax Number: | 3866150990 |
NPI Enumeration Date: | 11/15/2012 |
NPI Last Update Date: | 11/02/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 237700000X |
License Number: | AS 4908 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Hearing Instrument Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | Individuals who test hearing for the selection, adaptation, fitting, adjusting, servicing, and sale of hearing aids. Hearing Instrument Specialist is a designation provided individuals who qualify by the National Hearing Aid Society |