Provider Demographics
NPI:1396561536
Name:KRAMER, MIRYAM ZISSELE (SLP-CCC)
Entity type:Individual
Prefix:MRS
First Name:MIRYAM
Middle Name:ZISSELE
Last Name:KRAMER
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:MRS
Other - First Name:MIRYAM
Other - Middle Name:ZISSELE
Other - Last Name:FREEDMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP-CCC
Mailing Address - Street 1:216 PRIVATE WAY
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-2572
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:216 PRIVATE WAY
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-2572
Practice Address - Country:US
Practice Address - Phone:617-615-1065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-03
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist