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General NPI Number Information
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NPI Number | 1003146051
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Entity Type | Individual
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Provider Name | MARCIA SUE WAYMOUTH CCC-A
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Gender | Female
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Dates
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Enumeration Date | 01/13/2010
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Last Update Date | 01/13/2010
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Provider Practice Location Address
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Address Line | 2614 E SEVENTH ST
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City | CHARLOTTE
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State | NC
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Zip | 28204-4375
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Country | US
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Telephone | 704-376-1220
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Fax |
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Provider Business Mailing Address
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Address Line | 13329 WILLOW BREEZE
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-9621
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Country | US
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Telephone | 704-987-8631
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | 4726
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | 937
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License Number State | NC
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