Provider Demographics
NPI:1518231604
Name:ZIEMBA, NINA MARIE (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:MARIE
Last Name:ZIEMBA
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:NINA
Other - Middle Name:MARIE
Other - Last Name:DEPALMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:460 MAGDALA PL
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-6686
Mailing Address - Country:US
Mailing Address - Phone:860-681-1099
Mailing Address - Fax:
Practice Address - Street 1:911 S HUGHES ST
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-7731
Practice Address - Country:US
Practice Address - Phone:919-363-6117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-07
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202006407235Z00000X
NC10424235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist