Provider Demographics
NPI:1891123808
Name:ZIEMER, ANGELA MARIE (SLP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIE
Last Name:ZIEMER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:MARIE
Other - Last Name:WICHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:6700 ANTIOCH RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:MERRIAM
Mailing Address - State:KS
Mailing Address - Zip Code:66204-1497
Mailing Address - Country:US
Mailing Address - Phone:888-652-9225
Mailing Address - Fax:888-652-9198
Practice Address - Street 1:6700 ANTIOCH RD
Practice Address - Street 2:SUITE 120
Practice Address - City:MERRIAM
Practice Address - State:KS
Practice Address - Zip Code:66204-1497
Practice Address - Country:US
Practice Address - Phone:888-652-9225
Practice Address - Fax:888-652-9198
Is Sole Proprietor?:No
Enumeration Date:2013-10-30
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01630235Z00000X
KS852235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist