Individual
MS. NICHELEI ANISSA TALMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCCA
Contact information
Practice address
4001 HIGHWAY 36 S, BRENHAM, TX 77833-9610
(979) 836-4511
(979) 277-1865
Mailing address
4001 HIGHWAY 36 S, BRENHAM, TX 77833-9610
(979) 836-4511
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
80613
TX
231H00000X
Audiologist
AUD003741
GA
237600000X
Audiologist-Hearing Aid Fitter
AUD003741
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
64BCBPT
MEDICARE
GA
05
—
809412356A
—
GA
Enumeration date
07/10/2006
Last updated
01/13/2016
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