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:
Health care specialties
| Specialty | Code | License # | 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 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376162479 | NPPES |
| Georgia | MEDICAID | 003232001C | |
| Georgia | MEDICAID | 003232001B |
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