Provider Demographics
NPI:1548428956
Name:THIEMKEY, ROBERTA L (MA,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ROBERTA
Middle Name:L
Last Name:THIEMKEY
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 HOLCOMBE COVE RD
Mailing Address - Street 2:
Mailing Address - City:CANDLER
Mailing Address - State:NC
Mailing Address - Zip Code:28715
Mailing Address - Country:US
Mailing Address - Phone:828-665-9849
Mailing Address - Fax:828-665-9711
Practice Address - Street 1:95 HOLCOMBE COVE RD
Practice Address - Street 2:
Practice Address - City:CANDLER
Practice Address - State:NC
Practice Address - Zip Code:28715-9450
Practice Address - Country:US
Practice Address - Phone:828-667-9851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7264235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist