Doctor Name: | KARLYE K. NIEMAN |
NPI Number: | 1235366543 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SAC |
License Number: | 14544131 |
Business Practice Address: | 320 21st St N Menomonie, WI - 547512228 |
Business Phone Number: | 7152354537 |
Business Fax Number: | 7152354535 |
Mailing Address: | E9161 639th Ave, ELK MOUND |
State: | WI |
Postal Code: | 547399390 |
Phone Number: | 7156423056 |
Fax Number: | |
NPI Enumeration Date: | 06/12/2009 |
NPI Last Update Date: | 06/12/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 14544131 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |