Provider Demographics
NPI:1346909835
Name:NIEMEIER, CAROLINE (CCC-SLP, CBS)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:NIEMEIER
Suffix:
Gender:F
Credentials:CCC-SLP, CBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 GRIMES BRIDGE RD STE B
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-3900
Mailing Address - Country:US
Mailing Address - Phone:404-625-4152
Mailing Address - Fax:
Practice Address - Street 1:1160 GRIMES BRIDGE RD
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-3991
Practice Address - Country:US
Practice Address - Phone:470-423-9477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-11
Last Update Date:2022-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA174N00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No174N00000XOther Service ProvidersLactation Consultant, Non-RN