Basic Information
| Provider Information | |||||||||
| NPI: | 1093756421 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | FEBO | ||||||||
| FirstName: | DASHIELLE | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | AU.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2900 VETERANS WAY | ||||||||
| Address2: | AUDIOLOGY SERVICE | ||||||||
| City: | VIERA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 329408007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3216373788 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2900 VETERANS WAY | ||||||||
| Address2: | BREVARD OUTPATIENT CLINIC, AUDIOLOGY SERVICE | ||||||||
| City: | VIERA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 329408007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3216373788 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2006 | ||||||||
| LastUpdateDate: | 06/04/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | AY1210 | FL | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.