Provider Demographics
NPI:1306850979
Name:HEMRIC, BLISS (MA CCC SLP)
Entity Type:Individual
Prefix:
First Name:BLISS
Middle Name:
Last Name:HEMRIC
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 UNIVERSITY HALL DRIVE
Mailing Address - Street 2:ROOM 120
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28608-2041
Mailing Address - Country:US
Mailing Address - Phone:828-262-2185
Mailing Address - Fax:828-262-6766
Practice Address - Street 1:400 UNIVERSITY HALL DRIVE
Practice Address - Street 2:ROOM 120
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28608-2041
Practice Address - Country:US
Practice Address - Phone:828-262-2185
Practice Address - Fax:828-262-6766
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1956235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC85771OtherBLUE CROSS BLUE SHIELD OF
NC7485771Medicaid