Individual provider · NPI-1

Angela Marie Cissom, AuD

Audiologist · Memphis, TN

NPI number1891045282
StatusActive
Last updated in NPPESNov 8, 2016

Details

NPI
1891045282
Entity type
Individual (NPI-1)
Name
Mrs. Angela Marie Cissom
Credential
AuD
Sex
Female
Sole proprietor
No
Enumeration date
Sep 13, 2012
Last updated
Nov 8, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
231H00000X Audiologist01274MDYes

Practice location

4646 Poplar Ave
Suite 100
Memphis, TN 38117-4426

Phone 901-762-0125 · Fax 901-818-3001

Mailing address

4646 Poplar Ave
Suite 100
Memphis, TN 38117-4426

Phone 901-762-0125 · Fax 901-818-3001

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Audiologist providers in Memphis, TN