Provider Demographics
NPI:1508214388
Name:NIEZ, ANNE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:NIEZ
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:
Other - Last Name:CAROTHERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1021 N GARFIELD ST
Mailing Address - Street 2:APT. 207
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-2597
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1021 N GARFIELD ST
Practice Address - Street 2:APT. 207
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-2597
Practice Address - Country:US
Practice Address - Phone:440-223-5726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-02
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202007550235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist