Individual
MR. DAVID EDWARD NICODEMUS JR.
Active
Individual
MR. DAVID EDWARD NICODEMUS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A.
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
PS007441L
PA
103TC0700X
Clinical Psychologist
Primary
PS007441L
PA
Other
Enumeration date
04/19/2007
Last updated
09/11/2025
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