Healthcare Provider Details

I. General information

NPI: 1346156775
Provider Name (Legal Business Name): TERRIE FARRIS HIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 KENNEDY MEMORIAL DR
WATERVILLE ME
04901-5131
US

IV. Provider business mailing address

481 LINCOLN ST
WATERVILLE ME
04901-4304
US

V. Phone/Fax

Practice location:
  • Phone: 207-872-0320
  • Fax:
Mailing address:
  • Phone: 207-872-0320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberTR20000517
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: