Provider Demographics
NPI:1588818785
Name:NIEMEYER, SHARON MARIE
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:MARIE
Last Name:NIEMEYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:MARIE
Other - Last Name:FISCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 2362
Mailing Address - Street 2:
Mailing Address - City:TAOS
Mailing Address - State:NM
Mailing Address - Zip Code:87571-2362
Mailing Address - Country:US
Mailing Address - Phone:575-758-1036
Mailing Address - Fax:
Practice Address - Street 1:1552 WEIMER
Practice Address - Street 2:
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571-2362
Practice Address - Country:US
Practice Address - Phone:575-758-1036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-14
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM#1370235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist