Individual
NIKOLAI IVANOV GRAMMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ADT
Contact information
Practice address
2 W AYLESBURY RD, TIMONIUM, MD 21093-4101
(410) 561-9591
(410) 561-9396
Mailing address
2 W AYLESBURY RD, TIMONIUM, MD 21093-4101
(410) 561-9591
(410) 561-9396
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1981
MD
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
MD
Other
Enumeration date
07/14/2020
Last updated
07/14/2020
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