Provider Demographics
NPI:1508180233
Name:HSIEH, MIRIAM N (SPEECH PATHOLOGIST)
Entity Type:Individual
Prefix:
First Name:MIRIAM
Middle Name:N
Last Name:HSIEH
Suffix:
Gender:F
Credentials:SPEECH PATHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1955 AUSTIN CT
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-2822
Mailing Address - Country:US
Mailing Address - Phone:951-203-9111
Mailing Address - Fax:
Practice Address - Street 1:600 N MOUNTAIN AVE STE A201
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4368
Practice Address - Country:US
Practice Address - Phone:909-271-2176
Practice Address - Fax:909-271-2176
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-24
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7714235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist