Individual
MR. NICK J DEWAAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC, NCC
Contact information
Practice address
1190 MOUNT AETNA RD, HAGERSTOWN, MD 21740-6833
(301) 514-5049
Mailing address
31 SUMTER DR, KEEDYSVILLE, MD 21756-1353
(301) 432-2940
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC1688
MD
Other
Enumeration date
02/21/2006
Last updated
07/08/2007
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