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General NPI Number Information
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NPI Number | 1760173181
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Entity Type | Individual
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Provider Name | MEGAN NIEDERMEYER
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Gender | Female
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Dates
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Enumeration Date | 05/17/2023
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Last Update Date | 05/17/2023
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Provider Practice Location Address
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Address Line | 140 E RAWSON AVE STE 317
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City | OAK CREEK
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State | WI
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Zip | 53154-1525
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Country | US
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Telephone | 262-287-0965
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Fax |
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Provider Business Mailing Address
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Address Line | 720 N DR MARTIN LUTHER KING JR DR APT 206
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City | MILWAUKEE
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State | WI
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Zip | 53203-2248
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Country | US
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Telephone | 708-267-4798
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 5197-154
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License Number State | WI
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