Provider Demographics
NPI:1306151733
Name:NIEMAN, DAVID ANDREW (MS)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ANDREW
Last Name:NIEMAN
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:903 EDMONDSON AVE
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4408
Mailing Address - Country:US
Mailing Address - Phone:410-455-0098
Mailing Address - Fax:410-455-0098
Practice Address - Street 1:903 EDMONDSON AVE
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4408
Practice Address - Country:US
Practice Address - Phone:410-455-0098
Practice Address - Fax:410-455-0098
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP3606101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral