Provider Demographics
NPI:1265252043
Name:ZIEMBA, NATALIE DEAN (APC)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:DEAN
Last Name:ZIEMBA
Suffix:
Gender:F
Credentials:APC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 WILDFLOWER TRL
Mailing Address - Street 2:
Mailing Address - City:DEMOREST
Mailing Address - State:GA
Mailing Address - Zip Code:30535-5558
Mailing Address - Country:US
Mailing Address - Phone:678-602-5989
Mailing Address - Fax:
Practice Address - Street 1:1745 THOMPSON BRIDGE RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-1717
Practice Address - Country:US
Practice Address - Phone:770-536-9903
Practice Address - Fax:770-536-9904
Is Sole Proprietor?:No
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC009976101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health