Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | LGP3606 | MD |
NPI | 1306151733 |
---|---|
Provider Name | Mr. David Andrew Nieman |
First Address | Catonsville, MD 21228-4408 |
Second Address | Catonsville, MD 21228-4408 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2010 |
Last Update Date | 10/08/2010 |