Provider Demographics
NPI:1467591230
Name:HISSNER, ANGELA R (MA, CCC-A, F-AAA)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:R
Last Name:HISSNER
Suffix:
Gender:F
Credentials:MA, CCC-A, F-AAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 OXFORD ST STE A
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:OH
Mailing Address - Zip Code:44622-1970
Mailing Address - Country:US
Mailing Address - Phone:330-602-8833
Mailing Address - Fax:330-602-8832
Practice Address - Street 1:335 OXFORD ST
Practice Address - Street 2:SUITE A
Practice Address - City:DOVER
Practice Address - State:OH
Practice Address - Zip Code:44622-1970
Practice Address - Country:US
Practice Address - Phone:330-602-8833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH01305231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist