Individual
DANIEL SCOTT NISWONGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPP
Contact information
Practice address
2327 LIME KILN LN, LOUISVILLE, KY 40222-3422
(502) 414-4557
Mailing address
6705 WILD FOX LN, PROSPECT, KY 40059-9479
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
295279
KY
Other
Enumeration date
11/04/2025
Last updated
11/04/2025
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