Provider Demographics
NPI:1467482950
Name:HILLIS, ANN M (MS CCC)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:M
Last Name:HILLIS
Suffix:
Gender:F
Credentials:MS CCC
Other - Prefix:MS
Other - First Name:ANN
Other - Middle Name:M
Other - Last Name:MACKIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 UNIVERSITY STATION A1100
Mailing Address - Street 2:1 UNIVERSITY STATION A1100 CMA 2200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78712
Mailing Address - Country:US
Mailing Address - Phone:512-471-3841
Mailing Address - Fax:512-232-1804
Practice Address - Street 1:2504 A WHITIS
Practice Address - Street 2:2504 A WHITIS CMA 2200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78712
Practice Address - Country:US
Practice Address - Phone:512-471-3841
Practice Address - Fax:512-232-1804
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14323235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX87794TOtherBCBS