Doctor Name: | MARY C NIX |
NPI Number: | 1134164320 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, CCC-SLP |
License Number: | SA7938 |
Business Practice Address: | 1775 Lewis Turner Blvd Suite 101 Fort Walton Beach, FL - 325471277 |
Business Phone Number: | 8502268279 |
Business Fax Number: | 8502268326 |
Mailing Address: | 1775 Lewis Turner Blvd, Suite 101 FORT WALTON BEACH |
State: | FL |
Postal Code: | 325471277 |
Phone Number: | 8502268279 |
Fax Number: | 8502268326 |
NPI Enumeration Date: | 06/19/2006 |
NPI Last Update Date: | 01/16/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA7938 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |