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Individual

PETER NIEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.S. CCC-SLP

Contact information

Practice address
2860 CHANNING WAY STE 100, IDAHO FALLS, ID 83404-7531
(208) 529-7923
Mailing address
2775 SAINT CLAIR RD APT N205, IDAHO FALLS, ID 83404-7403

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-2917
ID

Other

Enumeration date
11/21/2017
Last updated
11/21/2017
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