Provider Demographics
NPI:1689432478
Name:NIEDER, CARLI
Entity Type:Individual
Prefix:
First Name:CARLI
Middle Name:
Last Name:NIEDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6245 NW COUNTY ROAD 7001
Mailing Address - Street 2:
Mailing Address - City:AMORET
Mailing Address - State:MO
Mailing Address - Zip Code:64722-8598
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1884 NE COUNTY ROAD 5004
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:MO
Practice Address - Zip Code:64730-8684
Practice Address - Country:US
Practice Address - Phone:660-227-1257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist