Provider Demographics
NPI:1790823953
Name:MAYES, NINA (BC-HIS)
Entity Type:Individual
Prefix:MRS
First Name:NINA
Middle Name:
Last Name:MAYES
Suffix:
Gender:F
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1847 SW 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-5167
Mailing Address - Country:US
Mailing Address - Phone:352-629-4418
Mailing Address - Fax:352-351-4522
Practice Address - Street 1:1847 SW 1ST AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-5167
Practice Address - Country:US
Practice Address - Phone:352-629-4418
Practice Address - Fax:352-351-4522
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS2383237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist