Moldenhauer, Mariam

Moldenhauer, Mariam is an sole proprietor health care provider with primary practice located at 6035 Peachtree Rd Ste C1206035 , Doraville GA 30360-3230. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Moldenhauer, Mariam can be contacted via phone (770) 410-7719.

Contact Information

Primary practice address
6035 Peachtree Rd Ste C1206035 Doraville GA 30360-3230
Phone: (770) 410-7719
Fax: (770) 410-9510
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SLP010986 Georgia

Profile Details

NPI number 1376162479
LBN Legal business name Moldenhauer, Mariam
Credentials Master of Arts (MA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 9th, 2020
Last updated Feb 9th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376162479 NPPES
Georgia MEDICAID 003232001C
Georgia MEDICAID 003232001B

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