Provider Demographics
NPI:1366761843
Name:ROSNER, MIRIAM (CCC-SLP, ATP)
Entity type:Individual
Prefix:
First Name:MIRIAM
Middle Name:
Last Name:ROSNER
Suffix:
Gender:F
Credentials:CCC-SLP, ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5455 MERIDIAN MARKS RD NE STE 300
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-4722
Mailing Address - Country:US
Mailing Address - Phone:404-785-3763
Mailing Address - Fax:
Practice Address - Street 1:5455 MERIDIAN MARKS RD NE STE 300
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-4722
Practice Address - Country:US
Practice Address - Phone:404-785-3763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-24
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLPOO1276235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist