Basic Information
| Provider Information | |||||||||
| NPI: | 1982803904 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HIX | ||||||||
| FirstName: | DEBBIE | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | M.ED. CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1805 N JACKSON ST | ||||||||
| Address2: | SUITE 2-3, JACKSON MEDICAL PLAZA | ||||||||
| City: | TULLAHOMA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 373882290 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9313937964 | ||||||||
| FaxNumber: | 9314556308 | ||||||||
| Practice Location | |||||||||
| Address1: | 1805 N JACKSON ST | ||||||||
| Address2: | SUITE 2-3, JACKSON MEDICAL PLAZA | ||||||||
| City: | TULLAHOMA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 373882290 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9313937964 | ||||||||
| FaxNumber: | 9314556308 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2007 | ||||||||
| LastUpdateDate: | 07/11/2007 | ||||||||
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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 | 235Z00000X | SP0000001279 | TN | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.