Individual
NIKKI RAE WIEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LGPC
Contact information
Practice address
211 E FORT AVE, BALTIMORE, MD 21230-4628
(443) 708-7673
Mailing address
211 E FORT AVE, BALTIMORE, MD 21230-4628
(443) 708-7673
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LGP14865
MD
Other
Enumeration date
02/27/2024
Last updated
02/27/2024
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