Individual
MRS. ELAINE L HINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.,CCC-A
Contact information
Practice address
618 PEGRAM DR, TUPELO, MS 38801-6322
(662) 844-3583
(662) 840-8354
Mailing address
618 PEGRAM DR, P.O. BOX 2180, TUPELO, MS 38801-6322
(662) 844-3583
(662) 840-8354
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
A0254
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00075029
—
MS
01
—
00739433
AM SPEECH LGG HEARING ASC
MS
01
—
A0254
MS STATE BOARD OF HEALTH
MS
Enumeration date
03/06/2007
Last updated
07/09/2007
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