Provider Demographics
NPI:1023532389
Name:NIERENBERG, CATHERINE MARY (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:MARY
Last Name:NIERENBERG
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MISS
Other - First Name:CATHERINE
Other - Middle Name:MARY
Other - Last Name:CHUTHUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:37 FRIEND STREET
Mailing Address - Street 2:ELEMENT CARE INC
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01902
Mailing Address - Country:US
Mailing Address - Phone:781-715-6608
Mailing Address - Fax:781-715-6699
Practice Address - Street 1:37 FRIEND ST.
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01902
Practice Address - Country:US
Practice Address - Phone:781-715-6608
Practice Address - Fax:781-715-6684
Is Sole Proprietor?:No
Enumeration Date:2017-07-28
Last Update Date:2017-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3681235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist